Individual
DR. EDWIN E BOLDREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2485 HOSPITAL DR, ORCHARD PAVILION STE 200, MOUNTAIN VIEW, CA 94040-4101
(650) 988-7480
(650) 988-7482
Mailing address
2485 HOSPITAL DR, ORCHARD PAVILION STE 200, MOUNTAIN VIEW, CA 94040-4101
(650) 988-7480
(650) 988-7482
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G17069
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G170692
—
CA
01
—
180014997
MEDICARE RAILROAD
CA
Enumeration date
09/07/2005
Last updated
03/13/2013
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