MEDICARE: EDEN EMERGENCY MEDICAL GROUP INC

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
1	207P00000X	Emergency Medicine Physician	001645	CA

General Provider Information

NPI Number	:	1891786240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDEN EMERGENCY MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	PO BOX 734861
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-4861
Country	:	US
Telephone Number	:	800-225-0953
Fax Number	:	562-924-5830

Provider Business Practice Location Address
First Line	:	20103 LAKE CHABOT RD
Second Line	:	EMERGENCY DEPT
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-5305
Country	:	US
Telephone Number	:	209-342-2300
Fax Number	:	209-524-4240

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JONATHAN SCOTT MCWHORTER
Credential	:	MD
Telephone Number	:	706-859-8998

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	02/12/2020

Similar Medicare Providers

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1205787280 — ERICA MENG GUO DNP
Practice Location Address:

20103 LAKE CHABOT RD
CASTRO VALLEY, CA
94546-5305

Practice Phone: 510-727-3001
Practice Fax:

1134122179 — EDEN MEDICAL CENTER
Practice Location Address:

20103 LAKE CHABOT RD
CASTRO VALLEY, CA
94546-5305

Practice Phone: 510-537-1234
Practice Fax: 510-889-6506

1326045196 — FATMA KHAKOO MD
Practice Location Address:

20103 LAKE CHABOT RD
CASTRO VALLEY, CA
94546-5305

Practice Phone: 510-727-3256
Practice Fax: 510-727-3107

1669473195 — DR. BETH L EHRLICH AUD
Practice Location Address:

20101 LAKE CHABOT RD FL 3
CASTRO VALLEY, CA
94546-5305

Practice Phone: 510-886-3400
Practice Fax: 510-506-7729

1548251960 — DAVID EMMANUEL MOYAL PA
Practice Location Address:

20103 LAKE CHABOT RD , EMERGENCY DEPT
CASTRO VALLEY, CA
94546-5305

Practice Phone: 209-342-2300
Practice Fax: 209-524-4240

Directions to “EDEN EMERGENCY MEDICAL GROUP INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.