DR. THEODORE DURNER EDSON (NPI# 1679572572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679572572 |
| Entity Type | Individual |
| Full Name | DR. THEODORE DURNER EDSON |
| Credential | M.D. |
| Practice Address |
Naval Hospital Camp Pendleton Department of Surgery Camp Pendleton CA 92055-5191 |
| Mailing Address |
3456 Moon Field Dr Carlsbad CA 92008-5542 |
| Practice Telephone | 7607251354 |
| Mailing Telephone | 7607292018 |
| Mailing Fax Number | 7607250117 |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2011-05-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 80554 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
NAVAL HOSPITAL CAMP PENDLETON DEPARTMENT OF SURGERY |
| City | CAMP PENDLETON |
| State | CA |
| Zip Code | 92055-5191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629209 | Matthew Victor Reza | Student in an Organized Health Care Education/Training Program | Naval Hospital Camp Pendleton, 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-11-04 |
| 1427672583 | Megan Patrice Twite | Military Health Care Provider | Naval Hospital Camp Pendleton, 200 Mercy Circle, Camp Pendleton, CA 92055 | 2020-06-04 |
| 1598394066 | Hannah Elizabeth Skillman | Student in an Organized Health Care Education/Training Program | Naval Hospital Camp Pendleton, 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-04-06 |
| 1407481229 | Keifer Patrick Walsh | Student in an Organized Health Care Education/Training Program | Naval Hospital Camp Pendleton, 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-03-12 |
| 1831724855 | Michael Nathaniel Gaona | Military Health Care Provider | Naval Hospital Camp Pendleton, 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-03-10 |
| 1740815729 | Katherine E Hobbs | Student in an Organized Health Care Education/Training Program | Naval Hospital Camp Pendleton, Bx 555191 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-03-10 |
| 1194358747 | Alexander Joseph Vidunas | Dentist | Naval Hospital Camp Pendleton, Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-02-21 |
| 1326695776 | Conan Joyce Gonzalez | Student in an Organized Health Care Education/Training Program | Naval Hospital Camp Pendleton, 200 Mercy Circle, Camp Pendleton, CA 92055 | 2019-08-21 |
| 1134787062 | Elizabeth Conlon | Student in an Organized Health Care Education/Training Program | Naval Hospital Camp Pendleton, 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2019-06-05 |
| 1093239873 | Solomon Spears Nair | Student in an Organized Health Care Education/Training Program | Naval Hospital Camp Pendleton, 200 Mercy Circle Box 555191, Camp Pendleton, CA 92055 | 2017-08-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1235737164 | Tynesha Felice Calimquim | Dental Hygienist | Naval Hospital Camp Pendleton, Dental Department, 200 Mercy Circle, Oceanside, CA 92055 | 2020-10-13 |
| 1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
| 1689271603 | Lorena Santodomingo | Dental Hygienist | Bldg 210735 C Street, Camp Pendleton, CA 92055 | 2020-10-02 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
| 1306453956 | Lynne Marie Reardon | Dental Hygienist | Bldg 310515, Camp Pendleton, CA 92055 | 2020-09-28 |
| Find all providers in zip 92055 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821226143 | Amy Hernandez | Surgery | Po Box 555191, Camp Pendleton, CA 92055-5191 | 2009-06-25 |
| 1629338835 | Ashlie Nicole White | Surgery | 200 Mercy Circle, Naval Hospital Camp Pendleton, Camp Pendleton, CA 92055 | 2012-05-22 |
| 1285968370 | Victoria Shoko Divis Mcdonald | Surgery | 200 Mercy Circle, General Surgery Clinic, Camp Pendleton, CA 92055 | 2009-09-23 |
| 1326275678 | Radhames Eliel Lizardo | Surgery | Naval Hospital Camp Pendleton, 200 Mercy Circle, Camp Pendleton, CA 92055 | 2009-06-14 |
| 1598965493 | Robert Arnold | Surgery | Naval Hospital Camp Pendleton, Bldg H-100 Santa Margarita Road, Camp Pendleton, CA 92055-9151 | 2007-07-19 |
| 1538204060 | Matthew A Kuettel | Surgery | 200 Mercy Circle, Naval Hospital Camp Pendleton, Camp Pendleton, CA 92055 | 2007-02-21 |
| 1407826258 | William Charles Brunner | Surgery | 200 Mercy Circle, Naval Hospital Camp Pendleton, Camp Pendleton, CA 92055-5191 | 2006-01-25 |
| 1043299076 | Thanh Tuyen Thi Huynh | Surgery | U.S. Naval Hospital, Camp Pendleton, CA 92055 | 2006-01-10 |
| 1508842014 | Anthony Corey Boganey | Surgery | Naval Hospital Camp Pendleton, Department of General Surgery, Camp Pendleton, CA 92055 | 2005-12-16 |
| 1891793600 | Harold Ray Bohman | Surgery | Naval Hospital, Dept of Surgery, Camp Pendleton, CA 92055-5191 | 2005-07-14 |
| Find all providers in CAMP PENDLETON | ||||
| City | CAMP PENDLETON |
| Zip Code | 92055 |
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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.