Basic Information
| Provider Information | |||||||||
| NPI: | 1437337789 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BLEWS | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | ORVILLE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11370 ANDERSON ST | ||||||||
| Address2: | FACULTY MEDICAL OFFICES, SUITE 3650 | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923543450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095584906 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11370 ANDERSON ST | ||||||||
| Address2: | FACULTY MEDICAL OFFICES, SUITE 3650 | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923543450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095584906 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2008 | ||||||||
| LastUpdateDate: | 11/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | A105699 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207R00000X | A105699 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.