Healthcare Provider Details

I. General information

NPI: 1396078770
Provider Name (Legal Business Name): EROL DILLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 07/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517-750 WEST BROADWAY
VANCOUVER BC
V5Z 1H4
CA

IV. Provider business mailing address

517-750 WEST BROADWAY
VANCOUVER BC
V5Z 1H4
CA

V. Phone/Fax

Practice location:
  • Phone: 604-876-2313
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT196114
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: