Basic Information
| Provider Information | |||||||||
| NPI: | 1780657932 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDWARDS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21840 NORMANDIE AVE | ||||||||
| Address2: | STE. 700 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102225101 | ||||||||
| FaxNumber: | 3103205463 | ||||||||
| Practice Location | |||||||||
| Address1: | 21840 NORMANDIE AVE | ||||||||
| Address2: | STE. 700 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102225101 | ||||||||
| FaxNumber: | 3103205463 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | G19429 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.