Healthcare Provider Details

I. General information

NPI: 1396655247
Provider Name (Legal Business Name): MR. ERIC DANIEL CROWDER II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3208 ROSEMEAD BLVD STE 100
EL MONTE CA
91731-2830
US

IV. Provider business mailing address

2200 W 8TH ST APT 334
LOS ANGELES CA
90057-4008
US

V. Phone/Fax

Practice location:
  • Phone: 626-227-7014
  • Fax:
Mailing address:
  • Phone: 619-305-9941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: