DR. EDWIN HENRY DIETRICH (NPI# 1710221403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710221403 |
| Entity Type | Individual |
| Full Name | DR. EDWIN HENRY DIETRICH |
| Credential | MD |
| Practice Address |
1411 E 31st St Oakland CA 94602-1018 |
| Mailing Address |
2098 Fell St San Francisco CA 94117-1808 |
| Practice Telephone | 5104374564 |
| Mailing Telephone | 4436327654 |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2015-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
A129815 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 207P00000X EMERGENCY | 05 |
| Street Address |
1411 E 31ST ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94602-1018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396733135 | Andrea Elizabeth Williams | Family Medicine | 1411 E 31st St, Oakland, CA 94602-1018 | 2005-10-06 |
| 1972101186 | Jennifer Pham | Pharmacist | 1411 E 31st St, Oakland, CA 94602-1018 | 2020-10-12 |
| 1922606276 | Monica Mofidi | Registered Nurse | 1411 E 31st St, Oakland, CA 94602-1018 | 2020-10-09 |
| 1639785223 | Mercedeh Nicole Vaez | Dentist | 1411 E 31st St, Oakland, CA 94602-1018 | 2020-09-18 |
| 1962015701 | Egbe Iyabo Omoregie | Nurse Practitioner | 1411 E 31st St, Oakland, CA 94602-1018 | 2020-08-30 |
| 1275146672 | Jessica Labioda Sohn | Social Worker | 1411 E 31st St, Oakland, CA 94602-1018 | 2020-08-25 |
| 1760093462 | Himalina Rajanakhan | Registered Nurse | 1411 E 31st St, Oakland, CA 94602-1092 | 2020-08-14 |
| 1316558018 | Lisa De La Cruz | Registered Nurse | 1411 E 31st St, Oakland, CA 94602-1018 | 2020-08-14 |
| 1396356762 | Jermaine Robertson | Student in an Organized Health Care Education/Training Program | 1411 E 31st St, Oakland, CA 94602-1018 | 2020-08-11 |
| 1700496437 | Kathleen Puanani Hennessy | Pharmacist | 1411 E 31st St, Oakland, CA 94602-1018 | 2020-08-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376151845 | Nicholas Collins Pac Lac Inc | Acupuncturist | 3433 Brunell Dr, Oakland, CA 94602 | 2020-07-21 |
| 1225667850 | Elaine Dellinger | Student in an Organized Health Care Education/Training Program | Highland Hospital 1411 East 31st Street, Qic 22123, Oakland, CA 94602 | 2020-04-06 |
| 1356804033 | Jayakala Lakireddy | Student in an Organized Health Care Education/Training Program | Dept of Surgery, 1411 East 31st Street, Oakland, CA 94602 | 2019-04-10 |
| 1750844585 | Kirea J Mazzolini | Student in an Organized Health Care Education/Training Program | Dept. of Surgery, 1411 East 31st Street, Oakland, CA 94602 | 2019-04-09 |
| 1912478587 | Joie Mazor | Chiropractor | 3201 Macarthur Blvd., Oakland, CA 94602 | 2018-12-07 |
| 1114424884 | Jesse Santos | Student in an Organized Health Care Education/Training Program | Dept. of Surgery, 1411 East 31st Street, Oakland, CA 94602 | 2018-04-10 |
| 1679078646 | Tia Vang | Student in an Organized Health Care Education/Training Program | 1411 E. 31st Street 2nd Flr A2, Oakland, CA 94602 | 2018-03-29 |
| 1942704101 | Michael Mian | Student in an Organized Health Care Education/Training Program | 1411 E 31st St, Qic 22123, Oakland, CA 94602 | 2018-03-22 |
| 1063916575 | Charisma Kaushik | Student in an Organized Health Care Education/Training Program | 1411 East 31st Street, Qic 22123, Oakland, CA 94602 | 2018-03-20 |
| 1841711363 | David Christopher Carroll | Pharmacist | 1411 E. 31st Street, Oakland, CA 94602 | 2017-07-06 |
| Find all providers in zip 94602 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649423260 | Hacop Aslanian | Emergency Medicine | 1200 Lakeshore Ave, Oakland, CA 94606-1679 | 2008-10-28 |
| 1841709979 | Kristin Burgess Mcbride | Emergency Medicine | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2017-09-20 |
| 1962724948 | Roneesha Starr Knight | Emergency Medicine | 1411 E 31st St, Oakland, CA 94602-1018 | 2010-02-18 |
| 1639405640 | Tania A Sadoun | Emergency Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2009-10-26 |
| 1659522852 | Molly Keegan | Emergency Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2008-10-06 |
| 1699938704 | Melissa K. Middleton | Emergency Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2008-07-08 |
| 1770592149 | Jordan L Kramer | Emergency Medicine | 2107 Livingston St Ste A, Oakland, CA 94606-5218 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619576576 | Thethong P Thepvong | Emergency Medicine | 900 W Belgravia Ave, Fresno, CA 93706-3909 | 2020-10-21 |
| 1003441148 | Heather K Mineo | Emergency Medicine | 1908 Spahn Ln, Placentia, CA 92870-2844 | 2020-03-10 |
| 1407497837 | Jaskaranpreet Kaur Sahota | Emergency Medicine | 426 4th Street, Marysville, CA 95901 | 2019-10-07 |
| 1215493515 | Karla Beatriz Sonnier | Emergency Medicine | 17822 Cardiff Cir, Huntington Beach, CA 92649-4807 | 2019-02-12 |
| 1568992923 | American Specialty Physicians Group Inc | Emergency Medicine | 700 17th St Ste 205, Modesto, CA 95354-1249 | 2017-06-18 |
| 1841659067 | George Michael Savage | Emergency Medicine | 2600 Bridge Parkway, Proteus Digital Health, Redwood City, CA 94065 | 2016-02-16 |
| 1053779553 | Robert Alan Hochman | Emergency Medicine | 526 Firecrest Court, Newbury Park, CA 91320-5022 | 2016-01-29 |
| 1578954319 | Amerco Health Enterprise, Inc | Emergency Medicine | 1006 E Bastanchury Rd, Fullerton, CA 92835-2782 | 2015-02-16 |
| 1134543945 | Francine Vogler | Emergency Medicine | 22631 Pacific Coast Highway, #796, Malibu, CA 90265 | 2014-02-13 |
| 1396081659 | Kent Benedict | Emergency Medicine | 3283 Valencia Ave, Aptos, CA 95003-4122 | 2012-12-13 |
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| 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.