Healthcare Provider Details

I. General information

NPI: 1972697324
Provider Name (Legal Business Name): ERICA S. PAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 10/22/2025
Certification Date:
Deactivation Date: 01/31/2024
Reactivation Date: 10/22/2025

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-0106
US

IV. Provider business mailing address

1635 DIVISADERO STREET SUITE 625, BOX 1821
SAN FRANCISCO CA
94143
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-9197
  • Fax:
Mailing address:
  • Phone: 415-476-4029
  • Fax: 415-476-4150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA64555
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberA64555
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: