MARWAN EDRIS MD A PROFESSIONAL CORPORATION (NPI# 1205869427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205869427 |
| Entity Type | Organization |
| Organization Name | MARWAN EDRIS MD A PROFESSIONAL CORPORATION |
| Practice Address |
25283 Cabot Rd Ste 106 Suite 106 Laguna Hills CA 92653-5509 |
| Practice Telephone | 9493649080 |
| Practice Fax Number | 9493643856 |
| Mailing Telephone | 9493649080 |
| Mailing Fax Number | 9493643856 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2018-01-16 |
| Authorized Official Name | MR. MARWAN EDRIS (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 9493649080 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE ID NUMBER | W16626 | 01 |
| CA | LICENSE | A42896 | 01 |
| Street Address |
25283 CABOT RD STE 106 SUITE 106 |
| City | LAGUNA HILLS |
| State | CA |
| Zip Code | 92653-5509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
| 1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
| 1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
| 1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
| 1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
| 1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
| 1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
| 1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
| Find all providers in zip 92653 | ||||
| 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 |
|---|---|---|---|---|
| 1558691451 | Mozhgan Ashtari | Internal Medicine | 23141 Moulton Pkwy 202, Laguna Hills, CA 92653-1241 | 2009-12-28 |
| 1790951606 | Joao Daniel Trindade Fontes | Internal Medicine | 24022 Calle De La Plata Ste 500, Laguna Hills, CA 92653-7612 | 2008-05-01 |
| 1003941246 | Ralph Lowell Cummings | Internal Medicine | 24953 Paseo De Valencia Ste 15c, Laguna Hills, CA 92653-4344 | 2007-02-21 |
| 1922175413 | Hadi Mansoury | Internal Medicine | 24411 Health Center Dr Ste 620, Laguna Hills, CA 92653-3672 | 2006-11-29 |
| 1073603924 | Coastal Comprehensive Care Medical Center Inc | Internal Medicine | 25226 Cabot Rd, Laguna Hills, CA 92630 | 2006-10-13 |
| 1629165683 | Richard Howard Greengold, M.d., Inc. | Internal Medicine | 24953 Paseo De Valencia Ste 15b, Laguna Hills, CA 92653-4339 | 2006-10-09 |
| 1043306673 | Teneese Nguyen | Internal Medicine | 23141 Verdugo Dr, Ste 201, Laguna Hills, CA 92653-1341 | 2006-10-04 |
| 1255346797 | Reza Govashiri | Internal Medicine | 24421 Calle De La Louisa Ste 200, Laguna Hills, CA 92653-7609 | 2006-07-31 |
| 1497760219 | Bijan Movafegh-jooryabi | Internal Medicine | 22921 Triton Way Ste 125, Laguna Hills, CA 92653-1236 | 2006-07-30 |
| 1588690994 | Ali Reza Ghahraman | Internal Medicine | 24881 Alicia Pkwy Ste N, Laguna Hills, CA 92653-4617 | 2006-06-25 |
| Find all providers in LAGUNA HILLS | ||||
| City | LAGUNA HILLS |
| Zip Code | 92653 |
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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.