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NPI Code Detail

MEDICARE: EDGAR SEDRAKYAN N.P.

MEDICARE: EDGAR SEDRAKYAN N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner16702CA

General Provider Information

NPI Number : 1528105087
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDGAR SEDRAKYAN N.P.
Provider Business Mailing Address
First Line : PO BOX 15674
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91615-5674
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5205 MELROSE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90038-3144
Country : US
Telephone Number : 323-337-1828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 07/08/2007

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