Individual
ROBERT A EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
UCI MEDICAL CENTER, 101 THE CITY DRIVE SOUTH, ORANGE, CA 92868
(714) 456-2986
Mailing address
UCI DEPARTMENT OF PATHOLOGY, PO BOX 513377, LOS ANGELES, CA 90051-3377
(714) 456-2986
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
000000A79439
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A794390
BLUE SHIELD
CA
05
—
00A794390
—
CA
01
—
P00074905
RAILROAD MEDICARE
CA
01
—
WA79439A
MEDICARE PTAN
CA
Enumeration date
10/16/2006
Last updated
03/25/2008
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