Edwin Bashaw McClelland, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A84135 Issued in CA

Practice address

2055 3Rd Ave
Suite Number 100
San Diego, CA 92101-2037

Phone

(619) 233-8018

Fax

(619) 233-8020

NPI assigned

May 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: edwin.mcclelland.p1@direct.cdsdp.nextgenshare.com

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.

• Operation Samahan, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1194616268
  NPD (past)
• Mec Associates of Austin, L.L.P.

  • General Practice Physician
  • Austin, TX
  • NPI 1134268048
  NPD (past)

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1831306273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3733 SAN JOSE AVE",
            "address_2": "APT 5",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482264",
            "telephone_number": "858-531-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 3RD AVE",
            "address_2": "SUITE NUMBER 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012037",
            "telephone_number": "619-233-8018",
            "fax_number": "619-233-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAND",
        "first_name": "EDWIN",
        "middle_name": "BASHAW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A84135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donnie Sherrod McClease, M.S., CRC
• Ronald T McCleave, DDS
• Brandon Morgan McClellan, MD
• Linda McClellan
• Nickolas Tyler McClellan, IDC
• Kyra McClelland
• Brody McClendon
• Juwell Ashili McClendon, LCSW
• Kayla McClendon
• Rachelle Nicole McClenney, CRNA

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, 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 Dec 29, 2020; 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.