Doctor Name: | DR. EDWARD AUSTIN |
NPI Number: | 1245383488 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G66313 |
Business Practice Address: | 1331 E Compton Blvd Compton, CA - 902213401 |
Business Phone Number: | 3107634250 |
Business Fax Number: | 3107634062 |
Mailing Address: | 1331 E Compton Blvd, COMPTON |
State: | CA |
Postal Code: | 902213401 |
Phone Number: | 3107634250 |
Fax Number: | 3107634062 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 12/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G66313 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |