| Dr Philippe Edouard, MD | |
|
1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | |
| (707) 559-7500 | |
| (707) 559-7620 |
| Full Name | Dr Philippe Edouard |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 1179 N Mcdowell Blvd, Petaluma, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124029491 | NPI | - | NPPES |
| 00C512570 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | C51257 (California) | Primary |
| Entity Name | Providence Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346 |
| Entity Name | Petaluma Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588656268 PECOS PAC ID: 9133180375 Enrollment ID: O20050315000415 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Philippe Edouard, MD 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 Ph: (707) 559-7500 | Dr Philippe Edouard, MD 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 Ph: (707) 559-7500 |
Timothy M Sowerby, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 3900 Lakeville Hwy, Petaluma, CA 94954 Phone: 707-765-3900 | |
Roberto Gonzalez Huerta, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1383 N Mcdowell Blvd Ste 150, Petaluma, CA 94954 Phone: 707-308-2840 | |
Nina Rachel Molin, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1179 N Mcdowell Blvd, Petaluma, CA 94954 Phone: 707-559-7500 | |
Dr. Gerald S. Besses, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 124 Sunny Hill Dr, Petaluma, CA 94952 Phone: 707-658-2799 | |
Dr. Jeffrey Tobias, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 10 Lavender Ter, Petaluma, CA 94952 Phone: 650-200-8944 | |
Dr. Thomas Paton Knecht, MD, PHD Internal Medicine Medicare: Medicare Enrolled Practice Location: 141 Lynch Creek Way, Suite A, Petaluma, CA 94954 Phone: 707-762-0001 |