Healthcare Provider Details

I. General information

NPI: 1194350504
Provider Name (Legal Business Name): ERICA LE MORGENWECK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MERCY CIRCLE
OCEANSIDE CA
92055
US

IV. Provider business mailing address

200 MERCY CIRCLE
OCEANSIDE CA
92055
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-3784
  • Fax: 760-763-0905
Mailing address:
  • Phone: 760-725-3784
  • Fax: 760-763-0905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1194350504
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: