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General NPI Number Information
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NPI Number | 1295874022
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Entity Type | Individual
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Provider Name | EDMOND GIDON SARRAF M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 955 CARRILLO DR STE 210
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City | LOS ANGELES
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State | CA
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Zip | 90048
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Country | US
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Telephone | 310-888-7778
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Fax | 310-888-7732
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Provider Business Mailing Address
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Address Line | PO BOX 846
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City | BEVERLY HILLS
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State | CA
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Zip | 90213
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Country | US
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Telephone | 310-888-7778
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Fax | 310-888-7732
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A87551
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | A87551
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License Number State | CA
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