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General NPI Number Information
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NPI Number | 1811032550
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Entity Type | Organization
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Legal Business Name | EDWARD A. MENA, M.D., INC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 301 S FAIR OAKS AVE STE 305
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City | PASADENA
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State | CA
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Zip | 91105-2562
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Country | US
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Telephone | 266-440-7325
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Fax | 266-440-7310
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Provider Business Mailing Address
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Address Line | 301 S FAIR OAKS AVE STE 405
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City | PASADENA
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State | CA
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Zip | 91105-2562
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Country | US
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Telephone | 266-440-7325
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Fax | 626-440-7310
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD A. MENA
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Credential | M.D.
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Telephone | 626-440-7325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0008X
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Taxonomy Name | Hepatology Physician
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License Number | A73231
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License Number State | CA
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