Edward J Puttre Jr MD Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G22264 Issued in CA

Legal business name

EDWARD J PUTTRE JR MD INC

Practice address

1800 Western Ave
Suite 101
San Bernardino, CA 92411-1356

Phone

(909) 887-3937

Fax

(909) 887-9698

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edward J Puttre Jr., MD

Title

Owner

Phone

(909) 887-3937

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282521600000",
    "number": "1336281443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 WESTERN AVE",
            "address_2": "SUITE 101",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111356",
            "telephone_number": "909-887-3937",
            "fax_number": "909-887-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WESTERN AVE",
            "address_2": "SUITE 101",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111356",
            "telephone_number": "909-887-3937",
            "fax_number": "909-887-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD J PUTTRE JR MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2010-08-23",
        "status": "A",
        "authorized_official_last_name": "PUTTRE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-887-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G22264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G222640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Edem, NP
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• Edward G. Stokes, MD, Inc.
• Breanna Edwards
• Bria Edwards, LCSW
• Charneka Edwards
• Devin Wayne Edwards
• Lanita Marie Edwards

• Ophthalmology Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.