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NPI Code Detail

MEDICARE: DR. THOMAS ALAN EDELL M.D.

MEDICARE: DR. THOMAS ALAN EDELL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianL5318TX
2207LP2900XPain Medicine (Anesthesiology) PhysicianL5318TX

General Provider Information

NPI Number : 1114996360
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS ALAN EDELL M.D.
Provider Business Mailing Address
First Line : 11201 BENTON ST
Second Line :
City : LOMA LINDA
State : CA
Zip : 92357-1000
Country : US
Telephone Number : 909-801-5127
Fax Number :
Provider Business Practice Location Address
First Line : 11201 BENTON ST
Second Line :
City : LOMA LINDA
State : CA
Zip : 92357-1000
Country : US
Telephone Number : 909-801-5127
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 05/29/2026

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