MR. EDMAN FUENTES (NPI# 1013988955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013988955 |
| Entity Type | Individual |
| Full Name | MR. EDMAN FUENTES |
| Credential | PAC |
| Practice Address |
900 Greenley Rd Suite 914 Sonora CA 95370-5287 |
| Mailing Address |
5725 W Las Positas Blvd Suite 200 Pleasanton CA 94588-4054 |
| Practice Telephone | 9254696274 |
| Practice Fax Number | 9259241769 |
| Mailing Telephone | 9254696274 |
| Mailing Fax Number | 9259241769 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2014-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA51630 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 291613400 | 05 | |
| CA | MEDICAL LICENSE | PA51630 | 01 |
| FL | MEDICAL LICENSE | PA9102297 | 01 |
| Street Address |
900 GREENLEY RD SUITE 914 |
| City | SONORA |
| State | CA |
| Zip Code | 95370-5287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336131523 | Christi L Petersen | Registered Nurse | 900 Greenley Rd, Ste 922, Sonora, CA 95370-5287 | 2005-08-16 |
| 1881028843 | Jacquelyn Rose Cituk | Pharmacist | 900 Greenley Rd, Suite 908, Sonora, CA 95370-5287 | 2013-08-27 |
| 1053756916 | Kevin A. Orca | Pharmacist | 900 Greenley Rd, Ste 912, Sonora, CA 95370-5287 | 2013-05-06 |
| 1871804302 | Michael V Mcquiddy | Pharmacist | 900 Greenley Rd, Suite 912, Sonora, CA 95370-5287 | 2010-06-30 |
| 1255505764 | William G Stone | Surgery | 900 Greenley Rd, Sonora, CA 95370-5287 | 2008-04-15 |
| 1104027085 | Eric J. Hemminger | Internal Medicine | 900 Greenley Rd, Suite 915, Sonora, CA 95370-5287 | 2007-05-30 |
| 1538375365 | Brenda Joan Forrest | Internal Medicine | 900 Greenley Rd, Suite 922, Sonora, CA 95370 | 2007-05-16 |
| 1760519615 | Sonora Pulmonary and Critical Care Medicine, Professional Corporation | Internal Medicine | 900 Greenley Rd, Suite 923, Sonora, CA 95370-5287 | 2007-02-27 |
| 1932240587 | Lawrence E Brunel, M.d., Inc. | Specialist | 900 Greenley Rd, Suite 920, Sonora, CA 95370-5287 | 2007-02-08 |
| 1750469664 | Suneeta J. Chhugani | Internal Medicine | 900 Greenley Rd, Suite 922, Sonora, CA 95370-5287 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174056089 | Chris Neves | Case Management | 427 N Highway 49, Suite 305, Sonora, CA 95370 | 2017-04-07 |
| 1528433885 | Michael French Dds Dental Corporation | General Acute Care Hospital | 800 Morningstar Dr, Sonora, CA 95370 | 2015-12-11 |
| 1942681465 | Amanda Evans | Registered Nurse | 20111 Cedar Rd North, Sonor, CA 95370 | 2015-06-10 |
| 1043625916 | Cicely Chen | Obstetrics & Gynecology | 900 Greenley Rd, Suite 922 Adventist Health (sierra Ob/, Sonora, CA 95370 | 2014-06-30 |
| 1457781692 | Donnie E Campbell | Homeopath | 63 South Stewart St, Sonora, CA 95370 | 2013-11-26 |
| 1386078186 | Jo Ann M Rascon | Marriage & Family Therapist | 38 N Washington St, Suite F, Sonora, CA 95370 | 2013-08-28 |
| 1831449735 | Sami Rhodes | Case Manager/Care Coordinator | 427 N. Highway 49, Sonora, CA 95370 | 2012-09-18 |
| 1619225273 | Melissa Parrish | Registered Nurse | 20111 Cedar Rd. North, Sonora, CA 95370 | 2012-08-29 |
| 1295033504 | Magdalena Martinez Bauman | Marriage & Family Therapist | 175 Fairview Ln., Sonora, CA 95370 | 2011-03-10 |
| 1588804215 | Holly Gwendolyn Harris | Physical Therapist | 15274 Camino Del Parque Rd. S, Sonora, CA 95370 | 2009-02-20 |
| Find all providers in zip 95370 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699110429 | Andrew Tyler Suess | Physician Assistant | 680 Guzzi Ln Ste 102, Sonora, CA 95370-5288 | 2013-05-07 |
| 1710160353 | Stephanie Pike Mcdonald | Physician Assistant | 680 Guzzi Ln Ste 105, Sonora, CA 95370-5288 | 2007-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894403 | Kathlyn Larco | Physician Assistant | 1233 W Randall Way, West Covina, CA 91790-4747 | 2020-06-07 |
| 1487126421 | Eliza Hughes | Physician Assistant | 860 Oak Park Blvd Ste 101, Arroyo Grande, CA 93420-1800 | 2018-12-31 |
| 1508333873 | Andrew Cantos Malit | Physician Assistant | 409 Bristol Way, Corona, CA 92879-6156 | 2018-10-25 |
| 1578049458 | Ida Jelveh | Physician Assistant | 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 | 2018-07-13 |
| 1356833578 | Michael James Gonzalez | Physician Assistant | 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 | 2018-06-04 |
| 1023500592 | Pamela Lambert Pa-c, Inc. | Physician Assistant | 16105 Mariposa Ave, Riverside, CA 92504-8730 | 2018-05-31 |
| 1225532385 | Folsom Physicain Assistant First Assist, Inc | Physician Assistant | Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 | 2018-03-22 |
| 1275040008 | Gm Surgical Assistant Inc | Physician Assistant | 15615 Turnberry St, Moreno Valley, CA 92555-4901 | 2018-01-02 |
| 1902311186 | Or Solutions Inc | Physician Assistant | 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 | 2017-12-09 |
| 1184143828 | Alaa Abdalla Daghlas | Physician Assistant | 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 | 2017-09-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.