Provider Demographics
NPI:1508849795
Name:BINOYA, EDGARDO GABRIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGARDO
Middle Name:GABRIEL
Last Name:BINOYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19127 HOLMBURY AVE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7246
Mailing Address - Country:US
Mailing Address - Phone:562-860-6193
Mailing Address - Fax:562-866-4946
Practice Address - Street 1:10230 ARTESIA BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6763
Practice Address - Country:US
Practice Address - Phone:562-866-1500
Practice Address - Fax:562-866-4946
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30593208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A305930Medicaid
CA00A305930Medicaid
CAWA30593DMedicare PIN