Edwin Romel S. de Leon, M.D., Inc.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

A118530 Issued in CA

Legal business name

EDWIN ROMEL S. DE LEON, M.D., INC.

Practice address

208 W Highland Ave
San Bernardino, CA 92405-4018

Phone

(909) 886-3100

NPI assigned

Apr 28, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Edwin Romel Soriano De Leon, M.D.NPI 1871735464

Title

Chief Executive Officer

Phone

(714) 992-5853

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Edwin Romel Soriano De Leon, M.D.

  • Psychiatry Physician
  • The Dalles, OR
  • NPI 1871735464

  Child & Adolescent Psychiatry

  NPD (past) Authorized official

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1952836744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054018",
            "telephone_number": "909-886-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054018",
            "telephone_number": "909-886-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN ROMEL S. DE LEON, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "EDWIN ROMEL",
        "authorized_official_middle_name": "SORIANO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-992-5853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A118530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Wayne Edwards
• Lanita Marie Edwards
• Lincoln Paul Edwards, DDS
• Miya Edwards, MS
• Shanice Rose Edwards
• Catherine Efevberha, LMFT
• Edima Bassey Effiong, LVN
• Eric Alemnji Efuetngu, FNP-C
• Mavis Efuetngu, PMHNP
• Barbara Eileen Egan

• Child & Adolescent Psychiatry Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.