Search › California › 103TC0700X
Ellis Edmunds
NPI 1740595768 · on the registry since 2010 · sole proprietor
Practice
- Address
- 4243 Terrace St
Oakland, CA 94611 - Phone
- (510) 919-8366
Additional practice sites
- 2500 Bissell Ave, Richmond, CA
- 5478a College Ave, Oakland, CA
Registry record
- Primary taxonomy
- 103TC0700X
103TC0700X
- Also registered as
- 101Y00000X
390200000X - Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-07-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California