Provider Demographics
NPI:1962680611
Name:PARLAN L. EDWARDS, D.C., APC
Entity type:Organization
Organization Name:PARLAN L. EDWARDS, D.C., APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARLAN
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-583-0802
Mailing Address - Street 1:6354 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-5813
Mailing Address - Country:US
Mailing Address - Phone:619-583-0802
Mailing Address - Fax:619-583-2317
Practice Address - Street 1:6354 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-5813
Practice Address - Country:US
Practice Address - Phone:619-583-0802
Practice Address - Fax:619-583-2317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC9099111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW22402Medicare PIN