Provider Demographics
NPI:1902261845
Name:LAWAS, EDNA
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:
Last Name:LAWAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 N BUENA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2601
Mailing Address - Country:US
Mailing Address - Phone:626-650-3640
Mailing Address - Fax:
Practice Address - Street 1:3614 8TH AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-4110
Practice Address - Country:US
Practice Address - Phone:323-735-6003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker