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NPI Code Detail

MEDICARE: MARGARET ELIZABETH EDLEBECK

MEDICARE: MARGARET ELIZABETH EDLEBECK
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1871096347
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET ELIZABETH EDLEBECK
Provider Business Mailing Address
First Line : 4055 SEQUOIA ST APT 3
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-6163
Country : US
Telephone Number : 715-281-2436
Fax Number :
Provider Business Practice Location Address
First Line : 3517 CAMINO DEL RIO S STE 407
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4028
Country : US
Telephone Number : 619-955-8905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2018
Last Update Date : 03/19/2018

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Directions to “ MARGARET ELIZABETH EDLEBECK ” Practice Location

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