Organization
EDNA MA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDNA MA MD (PRESIDENT)
(310) 909-3344
Entity
Organization
Contact information
Practice address
14445 OLIVE VIEW DR, SYLMAR, CA 91342-1437
(818) 364-4350
Mailing address
119 N FAIRFAX AVE # 188, LOS ANGELES, CA 90036-2110
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A89363
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790996825
—
CA
Enumeration date
01/09/2014
Last updated
01/09/2014
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