Healthcare Provider Details

I. General information

NPI: 1558501304
Provider Name (Legal Business Name): ERIC HOTCHANDANI MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2009
Last Update Date: 05/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2523 EL PORTAL, SUITE 201
SAN PABLO CA
94806-3305
US

IV. Provider business mailing address

3800 COOLIDGE AVE
OAKLAND CA
94602
US

V. Phone/Fax

Practice location:
  • Phone: 510-439-3130
  • Fax: 510-439-3129
Mailing address:
  • Phone: 510-439-3130
  • Fax: 510-530-2047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: