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General NPI Number Information
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NPI Number | 1235586603
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Entity Type | Individual
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Provider Name | STEPHEN EDWARDS D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 200 MERCY CIRCLE
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City | CAMP PENDLETON
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State | CA
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Zip | 92055-5191
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Country | US
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Telephone | 760-719-3554
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Fax |
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Provider Business Mailing Address
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Address Line | 159 MONGRELLA DR
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City | OCEANSIDE
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State | CA
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Zip | 92058-7858
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Country | US
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Telephone | 303-718-6536
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 21098
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License Number State | CA
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