Provider Demographics
NPI:1417156225
Name:ENGLEMAN, EDGAR GEORGE (MD)
Entity Type:Individual
Prefix:PROF
First Name:EDGAR
Middle Name:GEORGE
Last Name:ENGLEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3373 HILLVIEW AVE
Mailing Address - Street 2:M/C 5556
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1204
Mailing Address - Country:US
Mailing Address - Phone:650-723-7960
Mailing Address - Fax:650-725-4470
Practice Address - Street 1:3373 HILLVIEW AVE
Practice Address - Street 2:M/C 5556
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1204
Practice Address - Country:US
Practice Address - Phone:650-723-7960
Practice Address - Fax:650-725-4470
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24766207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine