Healthcare Provider Details

I. General information

NPI: 1689785842
Provider Name (Legal Business Name): EDWARD PAUL STANLEY R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 BARRANCA PKWY
IRVINE CA
92606-8226
US

IV. Provider business mailing address

4790 IRVINE BLVD SUITE 105-355
IRVINE CA
92620-1973
US

V. Phone/Fax

Practice location:
  • Phone: 949-552-6266
  • Fax: 714-836-7034
Mailing address:
  • Phone: 949-552-6266
  • Fax: 714-836-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number286952
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number286952
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: