Healthcare Provider Details

I. General information

NPI: 1457956872
Provider Name (Legal Business Name): ERIK ENG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PARNASSUS AVE
SAN FRANCISCO CA
94143-2203
US

IV. Provider business mailing address

500 PARNASSUS AVE
SAN FRANCISCO CA
94143-2203
US

V. Phone/Fax

Practice location:
  • Phone: 415-883-0944
  • Fax: 415-476-9516
Mailing address:
  • Phone: 415-883-0944
  • Fax: 415-476-9516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA95002023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: