Individual provider Active NPI

David A Edwards, M.D.

  • Optometrist
  • Poway, CA
National Provider Identifier
1013924893
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
C33181 Issued in CA
Practice address
15708 Pomerado Rd
Suite N 202
Poway, CA 92064-2066
Phone
(858) 485-5600
Fax
(858) 485-5692
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X C33181 CA Primary

Addresses

Primary practice location

15708 Pomerado Rd
Suite N 202
Poway, CA 92064-2066

Mailing address

15708 Pomerado Rd
Suite N 202
Poway, CA 92064-2066
Phone (858) 485-5600

Other identifiers 1

IdentifierTypeStateIssuer
180025388OtherCARAILROAD MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C33181CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North County Ophthalmology Medical Group Past Accepting new patients
North County Eye Physicians, Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1013924893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15708 POMERADO RD",
            "address_2": "SUITE N 202",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642066",
            "telephone_number": "858-485-5600",
            "fax_number": "858-485-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15708 POMERADO RD",
            "address_2": "SUITE N 202",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642066",
            "telephone_number": "858-485-5600",
            "fax_number": "858-485-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "C33181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE  PTAN",
            "identifier": "180025388",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.