Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | DC11903 | CA |
N | 175L00000X | Homeopath | 0004 | CA |
N | 175L00000X | Homeopath | 1740595685 | ID |
NPI | 1740595685 |
---|---|
Provider Name | Dr. Edwin Carlyle Floyd |
First Address | Beverly Hills, CA 90212-3851 |
Second Address | Los Angeles, CA 90045-1908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2010 |
Last Update Date | 18/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1740595685 | SOLE PROVIDER (01) |