Individual
SCOTT A EDELSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A-C
Contact information
Practice address
101 BODIN CIR, 101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-2300
Mailing address
101 BODIN CIR, 60 MDG/SGCS, TRAVIS AFB, CA 94535-1809
(707) 423-2300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
009553
NY
363AS0400X
Surgical Physician Assistant
Primary
0010-01875
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02511360
—
NY
Enumeration date
05/26/2006
Last updated
12/15/2015
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