Provider Demographics
NPI:1508026766
Name:WAYNE, EDGAR MORRIS II (MD)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:MORRIS
Last Name:WAYNE
Suffix:II
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26800 CROWN VALLEY PKWY STE 275
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6384
Mailing Address - Country:US
Mailing Address - Phone:949-573-9510
Mailing Address - Fax:949-372-3564
Practice Address - Street 1:26800 CROWN VALLEY PKWY STE 275
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6384
Practice Address - Country:US
Practice Address - Phone:949-573-9510
Practice Address - Fax:949-372-3564
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA103826207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease