Dietrich, Edwin Henry

Dietrich, Edwin Henry is an individual health care provider with primary practice located at 1411 E 31St St , Oakland CA 94602-1018. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Dietrich, Edwin Henry can be contacted via phone (510) 437-4564.

Contact Information

Primary practice address
1411 E 31St St Oakland CA 94602-1018
Phone: (510) 437-4564
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X A129815 California

Profile Details

NPI number 1710221403
LBN Legal business name Dietrich, Edwin Henry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2012
Last updated Dec 16th, 2021 - about 5 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 1710221403 NPPES
California MEDICAID 207P00000X EMERGENCY

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