Doctor Name: | MR. EDGARDO ARCINUE |
NPI Number: | 1154415644 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | C39203 |
Business Practice Address: | 4650 W Sunset Blvd # 12 Los Angeles, CA - 900276062 |
Business Phone Number: | 3233617044 |
Business Fax Number: | 3233611022 |
Mailing Address: | 6430 W Sunset Blvd, LOS ANGELES |
State: | CA |
Postal Code: | 900287901 |
Phone Number: | 3233612337 |
Fax Number: | 3233618491 |
NPI Enumeration Date: | 10/02/2006 |
NPI Last Update Date: | 07/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C39203 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |