Healthcare Provider Details

I. General information

NPI: 1891889333
Provider Name (Legal Business Name): EDWARD ARTHUR BLOCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9320 TELSTAR AVE SUITE 226
EL MONTE CA
91731
US

IV. Provider business mailing address

9320 TELSTAR AVE SUITE 226
EL MONTE CA
91731
US

V. Phone/Fax

Practice location:
  • Phone: 626-569-6012
  • Fax: 626-569-9334
Mailing address:
  • Phone: 626-569-6012
  • Fax: 626-569-9334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG41386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: