Individual ProviderEdmund Walt JayDentistDental ProvidersPractice Address3737 Moraga Ave, Ste. B-300, San Diego, CA 92117-5404(858) 270-0682PECOS EnrollmentBased on the most recent information from CMS, provider Edmund Walt Jay 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 12:57 PM.Profile DetailsProvider ID1154711521Provider TypeIndividualFull NameJay, Edmund WaltTitleDr.CredentialD.D.S.GenderMaleSole ProprietorNoEnumeration Date1/23/2015Last Updated1/23/2015Contact InformationPractice LocationPractice Address3737 Moraga Ave, Ste. B-300, San Diego, CA 92117-5404Phone(858) 270-0682Fax(858) 270-0685Mailing LocationMailing Address3737 Moraga Ave, Ste. B-300, San Diego, CA 92117-5404Phone(858) 270-0682Fax(858) 270-0685Provider TaxonomiesCodeDescriptionLicenseCode122300000XPrimaryDescriptionDentistDental ProvidersLicense36384California