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Individual

EDWIN LEROY WARNER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
220 S BARNWELL ST, OCEANSIDE, CA 92054-4507
(619) 246-0561
Mailing address
626 E SYMMES ST APT B, NORMAN, OK 73071-5470
(405) 204-6046

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S083207059
DRIVER LICENSE
OK
Enumeration date
02/19/2020
Last updated
02/19/2020
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