Edwin Carlson, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

CAG021113 Issued in CA

Practice address

10 Woodland Rd
Saint Helena, CA 94574-9554

Phone

(707) 963-3611

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1174507552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "707-963-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "707-963-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "EDWIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "CAG021113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "CAG021113",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G211130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Butulia, RD
• Matthew Audet Cain, M.D.
• California Center for Families and Illness Inc
• Danny Cao, PHARMACIST
• David P Carelock, CRNA
• Gillian Lynch Casey, L.AC.
• Cenimation LLC
• Kelli A. Chase, M.D.
• Chuan-Jay J Chen, MD
• Cheryl Chong, D.O.

• Emergency Medicine Physician in Saint Helena, CA
• Providers in Saint Helena, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.