Provider Demographics
NPI:1093027278
Name:OBASARE, EDINRIN RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:EDINRIN
Middle Name:RAE
Last Name:OBASARE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EDINRIN
Other - Middle Name:RAE
Other - Last Name:OBASARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 WILSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7885
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 GARDEN CT STE B
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5302
Practice Address - Country:US
Practice Address - Phone:831-647-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127612207RC0001X
NY270955208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist