Edelson, H Dale

Edelson, H Dale is an sole proprietor health care provider with primary practice located at 5513 Philadelphia St Suite A, Chino CA 91710-7534. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Edelson, H Dale can be contacted via phone (909) 628-1226.

Contact Information

Primary practice address
5513 Philadelphia St Suite A Chino CA 91710-7534
Fax: (909) 628-5483
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 05806T California

Profile Details

NPI number 1386701068
LBN Legal business name Edelson, H Dale
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386701068 NPPES
California MEDICAID SD0058060

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