Individual
EDGAR D CORNEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
14175 W INDIAN SCHOOL RD STE B4-120, GOODYEAR, AZ 85395-8407
(956) 222-7774
Mailing address
14175 W INDIAN SCHOOL RD STE B4-120, GOODYEAR, AZ 85395-8407
(956) 222-7774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1100-P.A.
PR
Other
Enumeration date
10/21/2021
Last updated
01/11/2022
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