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General NPI Number Information
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NPI Number | 1396920450
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Entity Type | Organization
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Legal Business Name | THE HEALING EDGE VISION
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 408 LAURKRIS CT
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City | RIDGECREST
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State | CA
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Zip | 93555-3573
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Country | US
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Telephone | 760-384-2111
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Fax | 760-384-1901
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Provider Business Mailing Address
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Address Line | 408 LAURKRIS CT
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City | RIDGECREST
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State | CA
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Zip | 93555-3573
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Country | US
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Telephone | 760-384-2111
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Fax | 760-384-1901
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Authorized Official
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Title or Position | CEO
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Name | DR. PAUL FREDERICK STEMMER
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Credential | MD
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Telephone | 760-384-2111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G633470
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License Number State | CA
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