Healthcare Provider Details

I. General information

NPI: 1366497059
Provider Name (Legal Business Name): ERIC JON NEAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 OLIVE HIGHWAY SUITE #330
OROVILLE CA
95966
US

IV. Provider business mailing address

PO BOX 5040
OROVILLE CA
95966
US

V. Phone/Fax

Practice location:
  • Phone: 530-533-0774
  • Fax: 530-533-3568
Mailing address:
  • Phone: 530-532-8584
  • Fax: 530-532-8433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG79682
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: