Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A86165 | CA |
NPI | 1013048412 |
---|---|
Provider Name | Eric William Edmonds |
First Address | San Diego, CA 92123-4802 |
Second Address | San Diego, CA 92123-4232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 03/11/2011 |