Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0122X | Plastic and Reconstructive Surgery | 2008-01037 | NC |
Y | 2086S0122X | Plastic and Reconstructive Surgery | A91870 | CA |
NPI | 1184808438 |
---|---|
Provider Name | Dr. Edward Christopher Ray |
First Address | Los Angeles, CA 90051-0717 |
Second Address | West Hollywood, CA 90048-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2007 |
Last Update Date | 10/10/2016 |