Provider Demographics
NPI:1891814539
Name:SCHLIES, EDWARD ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ALLEN
Last Name:SCHLIES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2324 SANTA RITA RD
Mailing Address - Street 2:STE 10
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4152
Mailing Address - Country:US
Mailing Address - Phone:925-462-6441
Mailing Address - Fax:925-426-6851
Practice Address - Street 1:2324 SANTA RITA RD STE 10
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4150
Practice Address - Country:US
Practice Address - Phone:925-462-6441
Practice Address - Fax:925-426-6851
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG338392084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABH906ZMedicare PIN