MEDICARE: MR. EDWARDO CHAVELO WELDON CRNA

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	367500000X	Certified Registered Nurse Anesthetist	95001311	CA

General Provider Information

NPI Number	:	1952429607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARDO CHAVELO WELDON CRNA

Provider Business Mailing Address
First Line	:	937 FRANKLIN BLVD
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93246-4700
Country	:	US
Telephone Number	:	559-998-2648
Fax Number	:

Provider Business Practice Location Address
First Line	:	34800 BOB WILSON DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92134-4700
Country	:	US
Telephone Number	:	559-998-2648
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	05/05/2025

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