Healthcare Provider Details

I. General information

NPI: 1609038264
Provider Name (Legal Business Name): ERIC BRIAN NAASZ D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 N HARBOR BLVD
FULLERTON CA
92832-1520
US

IV. Provider business mailing address

704 N HARBOR BLVD
FULLERTON CA
92832-1520
US

V. Phone/Fax

Practice location:
  • Phone: 714-525-0225
  • Fax: 714-525-0141
Mailing address:
  • Phone: 714-525-0225
  • Fax: 714-525-0141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberE4907
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4907
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: