Healthcare Provider Details

I. General information

NPI: 1093993263
Provider Name (Legal Business Name): CHRISTOPHER PHILLIPE ERICKSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2008
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6605 NANCY RIDGE DR
SAN DIEGO CA
92121-2253
US

IV. Provider business mailing address

6605 NANCY RIDGE DR
SAN DIEGO CA
92121-2253
US

V. Phone/Fax

Practice location:
  • Phone: 858-750-2983
  • Fax: 858-750-2984
Mailing address:
  • Phone: 858-750-2983
  • Fax: 858-750-2984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberM6122
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License NumberA109927
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberM6122
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberA109927
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberA109927
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberA109927
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code207SM0001X
TaxonomyMolecular Genetic Pathology (Medical Genetics) Physician
License NumberA109927
License Number StateCA
# 8
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA109927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: