Provider Demographics
NPI:1073730511
Name:EDWARDS, OMEGA LAVON (MD)
Entity Type:Individual
Prefix:DR
First Name:OMEGA
Middle Name:LAVON
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3801 LAS POSAS RD
Mailing Address - Street 2:SUITE 106-B
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1427
Mailing Address - Country:US
Mailing Address - Phone:805-389-0099
Mailing Address - Fax:805-389-4884
Practice Address - Street 1:3801 LAS POSAS RD
Practice Address - Street 2:SUITE 106-B
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-1427
Practice Address - Country:US
Practice Address - Phone:805-389-0099
Practice Address - Fax:805-389-4884
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2012-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA103607207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease