Provider Demographics
NPI:1083867840
Name:EDWARD CHERLIN, M.D. INC.
Entity Type:Organization
Organization Name:EDWARD CHERLIN, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-352-0448
Mailing Address - Street 1:230 SOUTH 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2905
Mailing Address - Country:US
Mailing Address - Phone:760-352-0448
Mailing Address - Fax:760-362-8865
Practice Address - Street 1:230 SOUTH 8TH STREET
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2905
Practice Address - Country:US
Practice Address - Phone:760-352-0448
Practice Address - Fax:760-362-8865
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDWARD CHERLIN, M.D. INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC313632084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C313630Medicaid
CA00C313630Medicaid
CAC31363AMedicare PIN