# EDGARD M VERA MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871734921
- **Authorized official:** DR. EDGARD M VERA (OWNER)
- **Authorized official phone:** (760) 780-4179

## Contact information

- **Practice address:** 17207 JASMINE ST, 2, VICTORVILLE, CA 92395
- **Practice address phone:** (760) 780-4179
- **Practice address fax:** (760) 241-4591
- **Mailing address:** 17207 JASMINE ST STE 2, VICTORVILLE, CA 92395-8322
- **Mailing address phone:** (760) 780-4179
- **Mailing address fax:** (760) 241-4591

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RN0300X | Nephrology Physician | — | NULL | Yes |
| 207RN0300X | Nephrology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/19/2009
- **Last updated:** 07/09/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DP7161 | RAIL ROAD MEDICARE | CA |