Edward R Etzkorn, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G57149 Issued in CA

Practice address

19066 Magnolia St.
Huntington Beach, CA 92646

Phone

(714) 968-0068

NPI assigned

Jun 21, 2005

Last updated

Nov 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Interoperability endpoints

• Direct secure messaging: edwardetzkorn@hcpca.allscriptsdirect.net

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

• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Davita Medical Group Talbert California, P.C.

  dba Talbert Medical Group

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1477554012

  Internal Medicine

  NPD (past)
• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  NPD (past)
• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  NPD (past)
• Talbert Medical Group, P.C.

  dba Talbert Medical Group

  • Internal Medicine Physician
  • Fountain Valley, CA
  • NPI 1528069176
  NPD (past)
• Memorial Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1255523643
  NPD (past)

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1780680140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19066 MAGNOLIA ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926462232",
            "telephone_number": "714-968-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19066 MAGNOLIA ST.",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92646",
            "telephone_number": "714-968-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETZKORN",
        "first_name": "EDWARD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G57149",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "G57149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL #",
            "identifier": "00G571490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Rae Esser
• Laura Stutz Estanislau, OTR/L
• Jennifer Roxana Estrada-Melgar
• Ethan Nguyen MD Inc
• Nicole Darlene Ethridge, MA, LPC
• Vennesa Eubank, M.ED, BCBA
• Crystal Evans
• Evelyn Chan DDS Inc (Adams Ave Dental)
• Scott Douglass Ewing, M.D.
• Excellent Community Healthcare Center

• Internal Medicine Physician in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.