Provider Demographics
NPI:1164434676
Name:RHEE, EDWARD S (DPM)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:S
Last Name:RHEE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:966 S WESTERN AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-1013
Mailing Address - Country:US
Mailing Address - Phone:323-733-1500
Mailing Address - Fax:323-733-1724
Practice Address - Street 1:966 S WESTERN AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-1013
Practice Address - Country:US
Practice Address - Phone:323-733-1500
Practice Address - Fax:323-733-1724
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3845213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWE3845CMedicare PIN
CAU35827Medicare UPIN
CAWE3845BMedicare PIN