MEDICARE: DR. EDWARD LAW D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	E4079	CA

General Provider Information

NPI Number	:	1962459545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD LAW D.P.M.

Provider Business Mailing Address
First Line	:	151 N SUNRISE AVE STE 1409
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-2934
Country	:	US
Telephone Number	:	916-783-0496
Fax Number	:	916-783-9406

Provider Business Practice Location Address
First Line	:	1280 E GIBSON RD
Second Line	:
City	:	WOODLAND
State	:	CA
Zip	:	95776-6315
Country	:	US
Telephone Number	:	530-661-4416
Fax Number	:	530-661-4416

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

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	03/11/2026

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