Henry Edelstein, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G25565 Issued in CA

Practice address

410 North Taylor Ave
Weaverville, CA 96093-1229

Phone

(530) 623-5541

NPI assigned

Oct 10, 2006

Last updated

Dec 2, 2008By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

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• Valley Emergency Physicians Medical Group, Inc

  dba Mercy Mt. Shasta Medical Corporation

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  • NPI 1497849574
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The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1962599886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10609",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926850609",
            "telephone_number": "877-818-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 NORTH TAYLOR AVE",
            "city": "WEAVERVILLE",
            "state": "CA",
            "postal_code": "960931229",
            "telephone_number": "530-623-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELSTEIN",
        "first_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G25565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G255650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yoni Lee Desmond, CAS
• Timothy Dobbs
• Donald E. Krouse, M.D., Inc
• Tuee Duong
• Julie Eaker, PHYSICIAN ASSISTANT
• Sara Edwards
• Sandra Lee Ekman
• Felice Ann Elias, L.AC.
• Richard Elorriaga, BA
• Robert John English, DO

• Emergency Medicine Physician in Weaverville, CA
• Providers in Weaverville, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.