MR. ELIAS CEDILLO IV (NPI# 1225400104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225400104 |
| Entity Type | Individual |
| Full Name | MR. ELIAS CEDILLO IV |
| Credential | IDC |
| Practice Address |
5905 34th Ave S Minneapolis MN 55450-2900 |
| Practice Telephone | 6127134849 |
| Mailing Telephone | 6127134849 |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
CA | Other Service Providers |
| Street Address |
5905 34TH AVE S |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55450-2900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174738793 | Mark Allen Taylor | Military Health Care Provider | 5905 34th Ave S, Minneapolis, MN 55450-2900 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922589373 | American Current Care of Minnesota PC | Clinic/Center | 7550 34th Ave S, Minneapolis, MN 55450 | 2018-08-23 |
| 1770567810 | William R Isaksen | Preventive Medicine | 7550 34th Ave S, Minneapolis, MN 55450-1124 | 2005-12-02 |
| 1063995629 | David Benjamin Clark | Registered Nurse | 7550 34th Ave S, Minneapolis, MN 55450-1124 | 2018-09-10 |
| 1427539881 | Occupational Health Centers of Minnesota PC | Clinic/Center | 7550 34th Ave S, Minneapolis, MN 55450-1124 | 2018-08-23 |
| 1225588833 | U.S. Healthworks Medical Group of Minnesota, PC | Clinic/Center | 7550 34th Ave S, Minneapolis, MN 55450-1124 | 2016-10-06 |
| 1619347119 | Jennifer Gaynor | Physical Therapist | 7550 34th Ave S, Minneapolis, MN 55450-1124 | 2015-09-28 |
| 1902035603 | Health Activation Services, Pllc | Clinic/Center | 7550 34th Ave S, Minneapolis, MN 55450-1124 | 2009-07-02 |
| 1275671224 | Linda Joy Miller | Emergency Medicine | 7550 34th Ave S, Minneapolis, MN 55450-1124 | 2007-02-02 |
| 1073683124 | Erica A Eichhof | Physical Therapist | 7550 34th Ave S, Minneapolis, MN 55450-1124 | 2006-11-08 |
| 1376521203 | David Zanick | Preventive Medicine | 7550 34th Ave S, Minneapolis, MN 55450-1124 | 2005-12-30 |
| Find all providers in zip 55450 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174738793 | Mark Allen Taylor | Military Health Care Provider | 5905 34th Ave S, Minneapolis, MN 55450-2900 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043571904 | Evan Roubal | Military Health Care Provider | 12054 Mississippi Dr N, Champlin, MN 55316-2110 | 2012-06-06 |
| City | MINNEAPOLIS |
| Zip Code | 55450 |
Please comment or provide details below to improve the information on MR. ELIAS CEDILLO IV.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.