Edward Martin Keiderling, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G67393 Issued in CA

Practice address

400 N Pepper Ave
Arrowhead Regional Medical Center
Colton, CA 92324-1819

Phone

(909) 580-6240

Fax

(909) 580-6308

NPI assigned

Jul 31, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Vituity Healthcare Services PC

  • Family Medicine Physician
  • Colton, CA
  • NPI 1700642758
  Medicare reassignment NPD
• Vituity Physician Services PC

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1124884176
  Medicare reassignment NPD
• University Muslim Medical Association Inc

  dba UMMA Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1306547138
  NPD (past)
• University Muslim Medical Association Inc

  dba UMMA Health Dental Mobile Unit

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1619700200
  NPD (past)
• University Muslim Medical Association Inc

  dba Fremont Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1730421330
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457366841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5157",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924125157",
            "telephone_number": "909-580-6240",
            "fax_number": "909-580-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "ARROWHEAD REGIONAL MEDICAL CENTER",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-580-6240",
            "fax_number": "909-580-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIDERLING",
        "first_name": "EDWARD",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G67393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G673930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Takumi Kawashita, DO
• Mina Kazemi, D.O.
• Michael Aaron Kealiher, MD
• Prescilla Keeney, RN
• Teresa Keeney
• Kelker Professional Corporation (Lacasa Medical Group)
• Rumicko Kellenberger
• Leila Kelly
• Nona Denise Kelly, MFT
• Sukeshini P Kelly, RN

• Family Medicine Physician in Colton, CA
• Providers in Colton, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.