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NPI Code Detail

MEDICARE: EDIO CORPORATION

MEDICARE: EDIO CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacyPHY 50352CA
23336C0003XCommunity/Retail PharmacyPHY 50352CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
105-09755OTHERCANCPDP/NABP
2PHY 50352OTHERCACALIFORNIA STATE BOARD OF PHARMACY PERMIT
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730240946
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDIO CORPORATION
Provider Business Mailing Address
First Line : 5848 SANTA MONICA BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90038-2002
Country : US
Telephone Number : 323-871-2500
Fax Number : 323-871-2522
Provider Business Practice Location Address
First Line : 5848 SANTA MONICA BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90038-2002
Country : US
Telephone Number : 323-871-2500
Fax Number : 323-871-2522
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : YANA ZILBERMAN
Credential :
Telephone Number : 323-572-6901
Provider Enumeration Date : 12/12/2006
Last Update Date : 09/22/2010

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Directions to “EDIO CORPORATION ” Practice Location

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