Provider Demographics
NPI:1497727465
Name:MCCLAY, EDWARD F (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:F
Last Name:MCCLAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 25100
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-5100
Mailing Address - Country:US
Mailing Address - Phone:559-326-1222
Mailing Address - Fax:559-326-1230
Practice Address - Street 1:838 NORDAHL RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3599
Practice Address - Country:US
Practice Address - Phone:760-747-8935
Practice Address - Fax:760-466-0078
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG64594207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC34008Medicare ID - Type Unspecified