Healthcare Provider Details

I. General information

NPI: 1922630227
Provider Name (Legal Business Name): EDINGER PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 TALBERT AVE STE 201
FOUNTAIN VALLEY CA
92708-5153
US

IV. Provider business mailing address

9900 TALBERT AVE STE 201
FOUNTAIN VALLEY CA
92708-5153
US

V. Phone/Fax

Practice location:
  • Phone: 714-965-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HARRY PELLMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-965-2500