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General NPI Number Information
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NPI Number | 1730240946
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Entity Type | Organization
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Legal Business Name | EDIO CORPORATION
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 5848 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90038-2002
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Country | US
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Telephone | 323-871-2500
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Fax | 323-871-2522
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Provider Business Mailing Address
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Address Line | 5848 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90038-2002
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Country | US
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Telephone | 323-871-2500
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Fax | 323-871-2522
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | YANA ZILBERMAN
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Credential |
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Telephone | 323-572-6901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY 50352
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY 50352
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License Number State | CA
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