Provider Demographics
NPI:1447225792
Name:CHERLIN, EDWARD A (MD)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:A
Last Name:CHERLIN
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 1:29645 RANCHO CALIFORNIA RD STE 133
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5285
Mailing Address - Country:US
Mailing Address - Phone:951-695-6238
Mailing Address - Fax:800-670-4969
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD STE 133
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5285
Practice Address - Country:US
Practice Address - Phone:951-695-6238
Practice Address - Fax:800-670-4969
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC313632084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C313630Medicaid
CAC31363OtherMEDICAL BOARD
CA00C313630Medicaid
A34546Medicare UPIN