Edison, Jill Elizabeth

Edison, Jill Elizabeth is an individual health care provider with primary practice located at 435 Doyle Park Dr , Santa Rosa CA 95405-4515. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Edison, Jill Elizabeth can be contacted via phone (707) 527-9510.

Contact Information

Primary practice address
435 Doyle Park Dr Santa Rosa CA 95405-4515
Phone: (707) 527-9510
Fax: (707) 527-1306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X G81587 California

Profile Details

NPI number 1225039514
LBN Legal business name Edison, Jill Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Dec 6th, 2010 - about 14 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 1225039514 NPPES
California MEDICAID 00G815870

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