Healthcare Provider Details

I. General information

NPI: 1457490567
Provider Name (Legal Business Name): ERKAN EREREN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13031 NEWPORT AVE. SUITE 116 # 605
TUSTIN CA
92780-3572
US

IV. Provider business mailing address

13031 NEWPORT AVE. SUITE 116 # 605
TUSTIN CA
92780-3572
US

V. Phone/Fax

Practice location:
  • Phone: 714-333-5278
  • Fax:
Mailing address:
  • Phone: 714-333-5278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA 38915
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA38915
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: