Etzkorn, Edward R

Etzkorn, Edward R is an individual health care provider with primary practice located at 19066 Magnolia St. , Huntington Beach CA 92646. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Etzkorn, Edward R can be contacted via phone (714) 968-0068.

Contact Information

Primary practice address
19066 Magnolia St. Huntington Beach CA 92646
Phone: (714) 968-0068
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G57149 California
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X G57149 California

Profile Details

NPI number 1780680140
LBN Legal business name Etzkorn, Edward R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Nov 5th, 2012 - about 12 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 1780680140 NPPES
California Other 00G571490 MEDI CAL #

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