Individual
MR. EDGAR BURQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3550 LOS FLORES BLVD, APT. 12, LYNWOOD, CA 90262-2619
(310) 991-9252
Mailing address
3550 LOS FLORES BLVD, APT. 12, LYNWOOD, CA 90262-2619
(310) 991-9252
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA21504
CA
Other
Enumeration date
03/14/2011
Last updated
03/14/2011
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