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Individual

MR. EDEM ENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
701 W ARBOR VITAE ST, INGLEWOOD, CA 90301-3107
(310) 673-9925
(310) 673-9927
Mailing address
701 W ARBOR VITAE ST, INGLEWOOD, CA 90301-3107
(310) 673-9925
(310) 673-9927

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DME02592G
CA
Enumeration date
09/22/2006
Last updated
07/09/2007
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