Charles Sanford Egesdal, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A157470 Issued in CA

Practice address

3501 S Harbor Blvd
Santa Ana, CA 92704-6919

Phone

(714) 929-2300

NPI assigned

Apr 10, 2017

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

Medicare fee-for-service enrollment

Enrolled in HI

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

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.

• Straub Clinic & Hospital

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1457306508
  Medicare reassignment NPD
• Straub Clinic & Hospital

  • Community/Retail Pharmacy
  • Honolulu, HI
  • NPI 1295443216
  NPD
• Kapiolani Medical Center for Women & Children

  • Children's Hospital
  • Honolulu, HI
  • NPI 1043263080
  NPD (past)
• Straub Clinic & Hospital

  • Durable Medical Equipment & Medical Supplies
  • Honolulu, HI
  • NPI 1851443733
  NPD (past)

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1861925471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 S HARBOR BLVD",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046919",
            "telephone_number": "714-929-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S HARBOR BLVD",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046919",
            "telephone_number": "714-929-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGESDAL",
        "first_name": "CHARLES",
        "middle_name": "SANFORD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A157470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John H. Edwards, LCSW
• Michael Edwards, M.D., PHD
• Nancy Ann Edwards, SLPA
• Jamie Elizabeth Eftekhari, RN
• Kimberly Egan
• John Ehum, MD
• Jasmine Eide
• Lynn Maria Einarsson, MS, OT
• Michael J Einbund, MD
• Luana Eisenbrey

• Pediatrics Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.