Healthcare Provider Details

I. General information

NPI: 1184665200
Provider Name (Legal Business Name): CHARLES HOWARD EDWARDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD BLDG. 200, FLOOR ONE, SUITE 101
SALINAS CA
93906-3100
US

IV. Provider business mailing address

1615 BUNKER HILL WAY SUITE 100
SALINAS CA
93906-6013
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-4124
  • Fax: 831-759-6595
Mailing address:
  • Phone: 831-769-1304
  • Fax: 831-757-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG81670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: