OrganizationEdwin Iliff, M.D.,Inc.(La Jolla Emergency Physician'S Medical Group)Emergency MedicineAllopathic & Osteopathic PhysiciansPractice Address9888 Genesee Ave, La Jolla, CA 92037-1205(858) 626-6150(626) 447-0296PECOS EnrollmentBased on the most recent information from CMS, provider Edwin Iliff, M.D.,Inc. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1588694855Provider TypeOrganizationFull NameEdwin Iliff, M.D.,Inc.Other NameLa Jolla Emergency Physician'S Medical GroupSubpartNoEnumeration Date7/3/2006Last Updated7/21/2022Contact InformationPractice LocationPractice Address9888 Genesee Ave, La Jolla, CA 92037-1205Phone(858) 626-6150Fax(858) 626-7117Mailing LocationMailing AddressPO Box 661687, Arcadia, CA 91066-1687Phone(626) 447-0296Fax(626) 447-6057Authorized OfficialNameIliff, Edwin (Owner)Phone(858) 626-6150Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerCaliforniaProvider IdentifiersIDDescriptionIssuerIDGR0068010DescriptionMedicaidIssuerUnlistedCalifornia