Healthcare Provider Details

I. General information

NPI: 1215229018
Provider Name (Legal Business Name): ERIN COTTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN MCCLELLAN

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 01/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4327 GOLDEN CENTER DR
PLACERVILLE CA
95667-6287
US

IV. Provider business mailing address

4327 GOLDEN CENTER DR
PLACERVILLE CA
95667-6287
US

V. Phone/Fax

Practice location:
  • Phone: 530-621-7700
  • Fax: 530-621-7713
Mailing address:
  • Phone: 530-621-7700
  • Fax: 530-621-7713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA122049
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: