Healthcare Provider Details

I. General information

NPI: 1467643700
Provider Name (Legal Business Name): ERIC J. CURCIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 16TH ST SUITE 303
SANTA MONICA CA
90404-1235
US

IV. Provider business mailing address

1245 16TH ST SUITE 303
SANTA MONICA CA
90404-1235
US

V. Phone/Fax

Practice location:
  • Phone: 310-315-8900
  • Fax: 310-315-8902
Mailing address:
  • Phone: 310-315-8900
  • Fax: 310-315-8902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA102381
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA102381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: