Healthcare Provider Details

I. General information

NPI: 1780719690
Provider Name (Legal Business Name): ERICH ROSS PARKS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11879 KEMPER RD SUITE #3
AUBURN CA
95603-9021
US

IV. Provider business mailing address

11879 KEMPER RD SUITE #3
AUBURN CA
95603-9021
US

V. Phone/Fax

Practice location:
  • Phone: 530-885-3154
  • Fax: 530-885-3192
Mailing address:
  • Phone: 530-885-3154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC0147160
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: