Healthcare Provider Details

I. General information

NPI: 1285687723
Provider Name (Legal Business Name): DAVID EDELSOHN MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1387 SANTA RITA RD
PLEASANTON CA
94566-5643
US

IV. Provider business mailing address

PO BOX 7793
SAN FRANCISCO CA
94120-7793
US

V. Phone/Fax

Practice location:
  • Phone: 925-951-1366
  • Fax:
Mailing address:
  • Phone: 925-951-1366
  • Fax: 925-951-1385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID ALAN EDELSOHN
Title or Position: PRESIDENT
Credential: MD
Phone: 503-372-2740