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General NPI Number Information
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NPI Number | 1972821213
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Entity Type | Organization
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Legal Business Name | ANDREA GAYE EDWARDS MD INC
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 12/13/2012
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Provider Practice Location Address
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Address Line | 1663 DOMINICAN WAY SUITE 210
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1527
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Country | US
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Telephone | 831-475-8002
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Fax | 831-475-8580
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Provider Business Mailing Address
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Address Line | 1663 DOMINICAN WAY SUITE 210
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1527
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Country | US
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Telephone | 831-475-8002
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Fax | 831-475-8580
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANDREA GAYE EDWARDS
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Credential | M.D.
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Telephone | 650-248-9190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A83742
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License Number State | CA
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