JOHN S. EDELEN (NPI# 1831183383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831183383 |
Entity Type | Individual |
Full Name | JOHN S. EDELEN |
Credential | M.D. |
Practice Address |
3300 Webster St Suite 410 Oakland CA 94609-3117 |
Mailing Address |
3300 Webster St Suite 404-410 Oakland CA 94609-3117 |
Practice Telephone | 5105494220 |
Practice Fax Number | 5104330744 |
Mailing Telephone | 5105494220 |
Mailing Fax Number | 5104330744 |
Enumeration Date | 2005-09-09 |
Last Update Date | 2017-01-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G26272 | CA | Allopathic & Osteopathic Physicians |
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
G26272 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 00G262720 | 05 |
Street Address |
3300 WEBSTER ST SUITE 410 |
City | OAKLAND |
State | CA |
Zip Code | 94609-3117 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073517603 | James K. Mooney | Specialist | 3300 Webster St, Ste 710, Oakland, CA 94609-3117 | 2005-06-10 |
1174970461 | Malboubi Dental Corporation | Dentist | 3300 Webster St, Suite 905, Oakland, CA 94609-3117 | 2016-05-17 |
1245607456 | Hill Health Inc A Medical Corporation | Family Medicine | 3300 Webster St, Oakland, CA 94609-3117 | 2015-08-24 |
1669879714 | Catherine Logan Maier | Registered Nurse | 3300 Webster St, Suite 1200, Oakland, CA 94609-3117 | 2014-12-03 |
1124420658 | Brianna Nicole Cosentino | Physical Therapist | 3300 Webster St, 1201, Oakland, CA 94609-3117 | 2014-09-16 |
1477966919 | Jessica Tice | Physical Therapist | 3300 Webster St, 703, Oakland, CA 94609-3117 | 2014-06-03 |
1205174505 | Kelly Lee Wong | Internal Medicine | 3300 Webster St, 1000, Oakland, CA 94609-3117 | 2013-01-21 |
1770885741 | Rachel L Kay | Nurse Practitioner | 3300 Webster St, Suite 304, Oakland, CA 94609-3117 | 2010-11-24 |
1306146568 | Carolyn Jacobs Bernstein | Nurse Practitioner | 3300 Webster St, Oakland, CA 94609-3117 | 2010-10-21 |
1528378460 | John Alexander Gillean | Psychiatry & Neurology | 3300 Webster St, Suite 402, Oakland, CA 94609-3117 | 2010-10-13 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
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Taxonomy Code | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417157652 | Mitul Kadakia | Internal Medicine | 365 Hawthorne Ave Ste 201, Oakland, CA 94609-3114 | 2007-07-24 |
1407992001 | James Edward Lai | Internal Medicine | 365 Hawthorne Ave Ste 201, Oakland, CA 94609-3114 | 2007-01-30 |
1811047525 | Terrence C. Wong | Internal Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2007-01-12 |
1083788145 | William K Lee | Internal Medicine | 43 Yawpo Ave, Oakland, NJ 07436 | 2006-11-20 |
1104990266 | Navin Budhwani | Internal Medicine | 43 Yawpo Ave, Oakland, NJ 07436 | 2006-11-20 |
1720157167 | Ronald K. L. Szeto M.d. A Professional Corporation | Internal Medicine | 3100 Telegraph Ave, Suite 4103, Oakland, CA 94609-3210 | 2006-11-07 |
1295813079 | Robert A. Cooper | Internal Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2006-11-01 |
1689752479 | Ralph G. Brindis | Internal Medicine | 280 W Macarthur Blvd, Oakland, CA 94611-5642 | 2006-11-01 |
1588742381 | Garwood Gee | Internal Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2006-11-01 |
1124108808 | David H Montgomery | Internal Medicine | 43 Yawpo Ave, Oakland, NJ 07436 | 2006-10-16 |
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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.