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Individual
DR. MARK DAVID EDELSTEIN
Active
Individual
DR. MARK DAVID EDELSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
C41340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C41340(0)
MEDI-CAL PIN
CA
01
—
1177
SACRAMENTO CY. PROVIDER #
CA
01
—
1238
SAN JOAQUIN COUNTY MENTAL HEALTH DEPT.
CA
Enumeration date
08/14/2006
Last updated
03/20/2012
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