Provider Demographics
NPI:1508080383
Name:ALBUREZ, EDGAR RICARDO (LVN)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:RICARDO
Last Name:ALBUREZ
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8944 WATSON PL
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-3925
Mailing Address - Country:US
Mailing Address - Phone:619-241-6624
Mailing Address - Fax:619-498-8265
Practice Address - Street 1:1161 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3136
Practice Address - Country:US
Practice Address - Phone:619-498-8260
Practice Address - Fax:619-498-8265
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN208443164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse