Individual
EDWARD AHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4620 BEVERLY BLVD, LOS ANGELES, CA 90004-3102
(323) 462-6423
(323) 462-3904
Mailing address
4620 BEVERLY BLVD, LOS ANGELES, CA 90004-3102
(323) 462-6423
(323) 462-3904
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A40196
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A401960
—
CA
01
—
953951355
TAX ID #
CA
01
—
A29073
PTAN
CA
Enumeration date
03/21/2006
Last updated
11/06/2007
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