Healthcare Provider Details

I. General information

NPI: 1619903887
Provider Name (Legal Business Name): ERIC HEYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W LA VETA AVE STE 300
ORANGE CA
92868-4246
US

IV. Provider business mailing address

PO BOX 668
ARVADA CO
80001-0668
US

V. Phone/Fax

Practice location:
  • Phone: 714-332-5502
  • Fax:
Mailing address:
  • Phone: 303-422-9438
  • Fax: 303-422-9474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberG65232
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: