Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A122699 | CA |
Y | 2080P0205X | Pediatric Endocrinologist | 1250646590 | IL |
NPI | 1073873634 |
---|---|
Provider Name | Edward John Bellfield |
First Address | Los Angeles, CA 90027-6082 |
Second Address | Los Angeles, CA 90027-6082 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2012 |
Last Update Date | 03/12/2021 |