Healthcare Provider Details

I. General information

NPI: 1891051900
Provider Name (Legal Business Name): EDWIN ORLANDO POUZEAUD M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST # 498
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1000 W CARSON ST # 498
TORRANCE CA
90502-2004
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-3151
  • Fax: 323-254-9087
Mailing address:
  • Phone: 424-492-3116
  • Fax: 323-254-9087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: