Ardila, Edgar

Ardila, Edgar is an individual health care provider with primary practice located at 11705 Slate Ave Suite 200, Riverside CA 92505-5196. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Ardila, Edgar can be contacted via phone (951) 351-1346.

Contact Information

Primary practice address
11705 Slate Ave Suite 200 Riverside CA 92505-5196
Phone: (951) 351-1346
Fax: (951) 359-3748
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X A54539 California
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X A54539 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A54539 California

Profile Details

NPI number 1295729648
LBN Legal business name Ardila, Edgar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Dec 15th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295729648 NPPES
California MEDICAID 00A545391

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