Individual
DR. EDWIN HENRY DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1411 E 31ST ST, OAKLAND, CA 94602-1018
(510) 437-4564
Mailing address
2098 FELL ST, SAN FRANCISCO, CA 94117-1808
(443) 632-7654
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
A129815
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207P00000X EMERGENCY
—
CA
Enumeration date
11/19/2012
Last updated
12/16/2021
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