DR. EDWARD J PUTTRE JR. (NPI# 1912183955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912183955 |
| Entity Type | Individual |
| Full Name | DR. EDWARD J PUTTRE JR. |
| Credential | M.D. |
| Practice Address |
1800 Western Ave Ste 101 San Bernardino CA 92411-1352 |
| Practice Telephone | 9098873937 |
| Practice Fax Number | 9098879698 |
| Mailing Telephone | 9098873937 |
| Mailing Fax Number | 9098879698 |
| Enumeration Date | 2008-01-19 |
| Last Update Date | 2008-01-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | G22264 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CORPORATION NPI | 1336281443 | 01 |
| CA | 00G222640 | 05 |
| Street Address |
1800 WESTERN AVE STE 101 |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92411-1352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619537016 | Shaunice Renee Cox | Case Manager/Care Coordinator | 1604 Pennsylvania Street, San Bernardino, CA 92411 | 2019-06-18 |
| 1104327543 | Wilson Gomer M.d. Professional Medical Corporation | Clinic/Center | 1800 Western Ave Ste 103, San Bernardino, CA 92411 | 2018-02-21 |
| 1467883504 | Pedro Lynn Hayes | Nurse Practitioner | 1800 Medical Center Dr. #99, San Bernardono, CA 92411 | 2013-11-27 |
| 1184973505 | Maria G Villasenor Perez | Social Worker | 1002 W 7th St, San Bernardino, CA 92411 | 2012-08-30 |
| 1003140948 | Joe Mawad | Obstetrics & Gynecology | 1800 Western Ave Ste 204, San Bernardino, CA 92411 | 2009-09-24 |
| 1124255146 | Angie Bagheri Cook | Pediatrics | 565 N. Mount Vernon Ave, San Bernardino, CA 92411 | 2009-06-17 |
| 1770637365 | Paul Anthony Tenette | Pharmacist | Delta Drugs, 1666 N Medical Center Drive, San Bernadino, CA 92411 | 2007-01-22 |
| 1225117328 | Vinod Kumar Kaura | Internal Medicine | 1800 N Western Ave #303, San Bernardino, CA 92411 | 2006-11-02 |
| 1861582314 | Cecilia Talpa Quinones | Physician Assistant | 565 N. Mount Vernon Ave., San Bernardino, CA 92411 | 2006-10-13 |
| 1710075247 | Bramara Arya | Pediatrics | 1505 W. 17th Street, San Bernardino, CA 92411 | 2006-10-10 |
| Find all providers in zip 92411 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689031528 | Inland Empire Autism Spectrum Disorder Assessment Center of Excellence | Specialist | 1499 S Tippecanoe Ave, Building A, San Bernardino, CA 92415-0024 | 2016-01-22 |
| 1497046361 | Kaylene R Carr | Specialist | 1800 N. Western Ave Ste 204, San Bernardino, CA 92411-1353 | 2011-04-27 |
| 1982912267 | Valley Physical Therapy | Specialist | 688 N Arrowhead Ave Ste 101b, San Bernardino, CA 92401-1144 | 2010-09-20 |
| 1952462699 | Jim Parker Ferguson | Specialist | 1255 E Highland Avenue, Suite 108, San Bernardino, CA 92404 | 2006-12-13 |
| 1467513739 | Franklin M Chu Md Inc | Specialist | 489 E 21st Street, San Bernardino, CA 92404 | 2006-12-12 |
| 1043398282 | Hendrik Johannes De Jager | Specialist | 1850 S Waterman Ave, Suite A, San Bernardino, CA 92408-2852 | 2006-11-02 |
| 1639256647 | Neveen Tadros | Specialist | 150 Carousell Mall, San Bernardino, CA 92415-0001 | 2006-11-01 |
| 1356422935 | Nenita F. Iturzaeta M.d., Inc. | Specialist | 850 W Highland Ave, Suite A, San Bernardino, CA 92405-3855 | 2006-10-18 |
| 1356437099 | Luke I-jen Hsiao | Specialist | 756 E Highland Ave, San Bernardino, CA 92404-4005 | 2006-10-04 |
| 1093811622 | David Edison Fisher | Specialist | 1850 S. Waterman Ave, Suite E, San Bernardino, CA 92408 | 2006-09-14 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92411 |
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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.