Organization
EDGAR ENRIQUEZ, MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR ANTONIO ENRIQUEZ M.D. (PRESIDENT)
(310) 435-4450
Entity
Organization
Contact information
Practice address
27420 TOURNEY RD, SUITE 210, VALENCIA, CA 91355-5601
(661) 253-1353
(661) 253-1387
Mailing address
PO BOX 367, SOUTH PASADENA, CA 91031-0367
(661) 253-1353
(661) 253-1387
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A80489
CA
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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