| Marwan Edris Md A Professional Corporation | |
|
25283 Cabot Rd Ste 106 Suite 106 Laguna Hills CA 92653-5509 | |
| (949) 364-9080 | |
| (949) 364-3856 |
| Full Name | Marwan Edris Md A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 25283 Cabot Rd Ste 106, Laguna Hills, California |
| Authorized Official Name and Position | Marwan Edris (OWNER/PHYSICIAN) |
| Authorized Official Contact | 9493649080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marwan Edris Md A Professional Corporation 25283 Cabot Rd Ste 106 Suite 106 Laguna Hills CA 92653-5509 Ph: (949) 364-9080 | Marwan Edris Md A Professional Corporation 25283 Cabot Rd Ste 106 Suite 106 Laguna Hills CA 92653-5509 Ph: (949) 364-9080 |
| NPI Number | 1205869427 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 05/01/2024 |
| Medicare PECOS PAC ID | 1355254459 |
|---|---|
| Medicare Enrollment ID | O20031105000825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205869427 | NPI | - | NPPES |
| W16626 | Other | CA | MEDICARE ID NUMBER |
| A42896 | Other | CA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Marwan Edris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013045970 PECOS PAC ID: 2163335266 Enrollment ID: I20031111000877 |
| Provider Name | Sami Edris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285194530 PECOS PAC ID: 6709116759 Enrollment ID: I20221122001849 |
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