Provider Demographics
NPI:1184665200
Name:EDWARDS, CHARLES HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:HOWARD
Last Name:EDWARDS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1615 BUNKER HILL WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-6013
Mailing Address - Country:US
Mailing Address - Phone:831-769-1304
Mailing Address - Fax:831-757-0291
Practice Address - Street 1:1441 CONSTITUTION BLVD
Practice Address - Street 2:BLDG. 200, FLOOR ONE, SUITE 101
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3100
Practice Address - Country:US
Practice Address - Phone:831-755-4124
Practice Address - Fax:831-759-6595
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-03-31
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Provider Licenses
StateLicense IDTaxonomies
CAG81670208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70126FMedicaid
CA00G816700Medicare PIN
CAFHC70126FMedicaid