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General NPI Number Information
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NPI Number | 1790460624
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Entity Type | Organization
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Legal Business Name | EDINGTON MEDICAL EVALUATIONS
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 1899 W MARCH LN
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City | STOCKTON
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State | CA
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Zip | 95207-6402
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Country | US
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Telephone | 209-623-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 1899 W MARCH LN
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City | STOCKTON
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State | CA
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Zip | 95207-6402
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Country | US
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Telephone | 209-623-4700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHILIP ALAN EDINGTON
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Credential | MD
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Telephone | 209-623-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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