Individual
EDWARD HENEVELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10121 PINE AVE, TRUCKEE, CA 96161-4835
(530) 582-3209
(530) 582-3201
Mailing address
PO BOX 2488, OLYMPIC VALLEY, CA 96146-2488
(530) 583-1817
(530) 583-1557
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G29319
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G293190
—
CA
Enumeration date
06/24/2006
Last updated
01/08/2013
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