Provider Demographics
NPI:1336268457
Name:EDWARDS, NANCY B (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:B
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13336 CHANDLER BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-5323
Mailing Address - Country:US
Mailing Address - Phone:818-995-3509
Mailing Address - Fax:818-788-6298
Practice Address - Street 1:1240 N MISSION RD
Practice Address - Street 2:L919
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1019
Practice Address - Country:US
Practice Address - Phone:323-226-3369
Practice Address - Fax:323-226-3440
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC333782080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG20663Medicare UPIN