| Doctor Name: | DR. LANCE DUSTIN EDMONDS |
| NPI Number: | 1124214374 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 01062204A |
| Business Practice Address: | 101 Bodin Cir Mdts/sgqx Travis Afb, CA - 945351809 |
| Business Phone Number: | 7074237182 |
| Business Fax Number: | |
| Mailing Address: | 10470 Old Placerville Rd, Suite 100 SACRAMENTO |
| State: | CA |
| Postal Code: | 958272539 |
| Phone Number: | 8004700071 |
| Fax Number: | |
| NPI Enumeration Date: | 09/21/2007 |
| NPI Last Update Date: | 07/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 01062204A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |