Fuentes, Edman

Fuentes, Edman is an individual health care provider with primary practice located at 900 Greenley Rd Suite 914, Sonora CA 95370-5287. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Fuentes, Edman can be contacted via phone (925) 469-6274.

Contact Information

Primary practice address
900 Greenley Rd Suite 914 Sonora CA 95370-5287
Phone: (925) 469-6274
Fax: (925) 924-1769
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA51630 California

Profile Details

NPI number 1013988955
LBN Legal business name Fuentes, Edman
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Jun 10th, 2014 - about 12 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 1013988955 NPPES
Florida MEDICAID 291613400
Florida Other PA51630
Florida Other PA9102297

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