DR. PHILIPPE EDOUARD (NPI# 1124029491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124029491 |
| Entity Type | Individual |
| Full Name | DR. PHILIPPE EDOUARD |
| Credential | MD |
| Practice Address |
1179 N Mcdowell Blvd Petaluma CA 94954-6559 |
| Practice Telephone | 7075597500 |
| Practice Fax Number | 7075597620 |
| Mailing Telephone | 7075597500 |
| Mailing Fax Number | 7075597620 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2019-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | C51257 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C512570 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1165 Montgomery Dr, Santa Rosa, CA 954054801 | 7075463210 | |
| 5900 State Farm Dr Ste 200, Rohnert Park, CA 949282149 | 7075597600 |
| Street Address |
1179 N MCDOWELL BLVD |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-6559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366445785 | Michelle Davey | Family Medicine | 1179 N Mcdowell Blvd, Petaluma, CA 94954 | 2005-05-31 |
| 1942809256 | Rachel Pradarelli | Nurse Practitioner | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2020-10-19 |
| 1518573161 | Cicily Raye Cooper | Nurse Practitioner | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2020-09-18 |
| 1912512492 | Andrea Akabike | Dentist | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2020-09-11 |
| 1306479381 | Leslie Ann Burger | Nurse Practitioner | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2020-02-18 |
| 1932759461 | Joanna Tripet-diel | Nurse Practitioner | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2019-09-17 |
| 1588214019 | Colette Long | Registered Nurse | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2019-09-17 |
| 1184274615 | Mario Marin Garcia | Physician Assistant | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2019-09-17 |
| 1073162541 | Luisa Rendon Ward | Social Worker | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2019-09-08 |
| 1801356605 | Kelly Marie Ware | Nurse Practitioner | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2019-03-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871710871 | Louis E Pelfini | Internal Medicine | 161 Lynch Creek Way, Petaluma, CA 94954-2343 | 2007-04-19 |
| 1093893596 | Michael B. Lennon | Internal Medicine | 412 Oak St, Petaluma, CA 94952-2709 | 2006-11-01 |
| 1942388749 | Marion L. Guyer | Internal Medicine | 905 E Washington St, Petaluma, CA 94952 | 2006-11-01 |
| 1336223320 | Amy C. Kaelin | Internal Medicine | 205 Stowring Rd, Petaluma, CA 94952-1056 | 2006-10-25 |
| 1124047311 | Gerald S. Besses | Internal Medicine | 124 Sunny Hill Dr, Petaluma, CA 94952-4749 | 2006-07-19 |
| 1295784346 | Ranadive Md Inc | Internal Medicine | 141 Lynch Creek Way Ste C, Petaluma, CA 94954-2390 | 2006-05-08 |
| 1275533887 | Thomas Owen Maloney | Internal Medicine | 108 Lynch Creek Way, #5, Petaluma, CA 94954-2357 | 2005-07-26 |
| 1972751915 | Saw Wynn Aye | Internal Medicine | 104 Lynch Creek Way, Ste 10, Petaluma, CA 94954-2355 | 2008-09-03 |
| 1245411529 | Northern California Medical Assoc Inc | Internal Medicine | 104 Lynch Creek Way, Ste 10, Petaluma, CA 94954-2355 | 2007-11-15 |
| 1316139066 | Kokeb Teshome | Internal Medicine | 400 N Mcdowell Blvd, Petaluma, CA 94954-2339 | 2007-08-16 |
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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.