Edgar Celis MD Inc

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

EDGAR CELIS MD INC

Practice address

1050 Northgate Dr Ste 460
San Rafael, CA 94903-2542

Phone

(415) 306-7641

Fax

(415) 526-3734

NPI assigned

Sep 17, 2018

Organization subpart

No

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

Authorized official

Name

Edgar Celis, MDNPI 1851473268

Title

Owner

Phone

(617) 372-3673

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edgar Gabriel Celis, M.D.

  • Anesthesiology Physician
  • San Rafael, CA
  • NPI 1851473268
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537142400000",
    "number": "1609350669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 NORTHGATE DR STE 460",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032542",
            "telephone_number": "415-306-7641",
            "fax_number": "415-526-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 NORTHGATE DR STE 460",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032542",
            "telephone_number": "415-306-7641",
            "fax_number": "415-526-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR CELIS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A",
        "authorized_official_last_name": "CELIS",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-372-3673",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Moriah Eckert
• Tamela Eckles
• Ecumenical Association for Housing, Inc.
• Tracie L Eddington-Bailey, LCSW
• Evan Edelist
• Sara Abbot Edrington, PSYD
• Holly Edson, NP
• Alexander Edwards, MS CCC SLP
• Damian Alfonso Edwards, CASE 1
• Mark Anthony Edwards, MS, MFT

• Interventional Pain Medicine Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.