Organization
FREDRIC L EDELMAN MD A PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL AGUILERA (MANAGER)
(818) 781-3350
Entity
Organization
Contact information
Practice address
16830 VENTURA BLVD STE 130, ENCINO, CA 91436-1786
(818) 781-3350
(818) 781-7237
Mailing address
16830 VENTURA BLVD STE 130, ENCINO, CA 91436-1786
(818) 781-3350
(818) 781-7237
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G15613
CA
207T00000X
Neurological Surgery Physician
G15613
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0079310
—
CA
Enumeration date
11/15/2007
Last updated
03/16/2022
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