Provider Demographics
NPI:1154362432
Name:KOLPIN, EDWARD CHRISTOPHER (DO)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CHRISTOPHER
Last Name:KOLPIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:KOLPIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:17747 CAMINO DE YATASTO
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2018
Mailing Address - Country:US
Mailing Address - Phone:310-459-6844
Mailing Address - Fax:310-626-9461
Practice Address - Street 1:17747 CAMINO DE YATASTO
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-2018
Practice Address - Country:US
Practice Address - Phone:310-459-6844
Practice Address - Fax:310-626-9461
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7423207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine