Edwin Carlisle Holland Jr. (NPI# 1376570077, PAC ID# 3072549526) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OSTEOPATHIC MANIPULATIVE MEDICINE.
| Nation Provider ID (NPI) | 1376570077 |
| PAC ID by PECOS | 3072549526 |
| Professional Enrollment ID | I20050715000277 |
| Full Name | Edwin Carlisle Holland Jr. |
| Address |
496 S Main St Sebastopol CA 95472-4211 |
| Phone Number | 7078248764 |
| Gender | M |
| Credential | DO |
| Graduation Year | 1977 |
| Primary Specialty | OSTEOPATHIC MANIPULATIVE MEDICINE |
| Secondary Specialties | FAMILY PRACTICE |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050174 | SANTA ROSA MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 496 S Main St, Sebastopol, CA 95472-4211 | 7078248764 |
| Street Address |
496 S MAIN ST |
| City | SEBASTOPOL |
| State | CA |
| Zip | 95472-4211 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nancy A Davidson | Family Practice | 6800 Palm Ave, Suite A, Sebastopol, CA 95472-2446 | |
| Andrew Stephen Wagner | Family Medicine | 819 Longwood Ln, Sebastopol, CA 95472-2734 | |
| Brian P Jacobs | Clinical Social Worker | 868 Gravenstein Hwy N, Sebastopol, CA 95472-2810 | |
| David Perry Molencupp | Chiropractic | 868 Gravenstein Hwy N, Sebastopol, CA 95472-2810 | |
| Barry Lynn Lutz | Optometry | 868 Gravenstein Hwy N, Sebastopol, CA 95472-2810 | |
| Richard S Schechter | Chiropractic | 868 Gravenstein Hwy N, Sebastopol, CA 95472-2810 | |
| Larry A Smith | Podiatry | 1035 Gravenstein Hwy N, Sebastopol, CA 95472-2811 | |
| Norman J Mintz | Optometry | 825 Gravenstein Hwy N, Suite 7, Sebastopol, CA 95472-2844 | |
| Julie Smith | Physical Therapy | 100 Pleasant Hill N, Sebastopol1, CA 95472-3104 | |
| Patricia D Martinez | Physical Therapy | 100 Pleasant Hill N Ave, Sebastopol, CA 95472-3104 | |
| Find all physicians in zip 95472 | |||
| City | SEBASTOPOL |
| Zip Code | 95472 |
| Specialty | OSTEOPATHIC MANIPULATIVE MEDICINE |
| City + Specialty | SEBASTOPOL + OSTEOPATHIC MANIPULATIVE MEDICINE |
Please comment or provide details below to improve the information on Edwin Carlisle Holland Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.