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NPI Code Detail

MEDICARE: DR. EDWARD M. OMRON M.D., M.P.H., FCCP

MEDICARE: DR. EDWARD M. OMRON M.D., M.P.H., FCCP
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
1207R00000XInternal Medicine PhysicianA105179CA
2207RC0200XCritical Care Medicine (Internal Medicine) Physician57533AZ
3207RC0200XCritical Care Medicine (Internal Medicine) PhysicianA105179CA
4207RP1001XPulmonary Disease PhysicianA105179CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134123755
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD M. OMRON M.D., M.P.H., FCCP
Provider Business Mailing Address
First Line : 18525 SUTTER BLVD
Second Line : SUITE 180
City : MORGAN HILL
State : CA
Zip : 95037-8100
Country : US
Telephone Number : 408-778-0022
Fax Number : 408-778-0055
Provider Business Practice Location Address
First Line : 6200 N LA CHOLLA BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85741-3529
Country : US
Telephone Number : 520-742-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 10/07/2025

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