Healthcare Provider Details

I. General information

NPI: 1972557502
Provider Name (Legal Business Name): ERIC M FIELDS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 N BRENT ST
VENTURA CA
93003-2854
US

IV. Provider business mailing address

1342 NE 62ND ST
SEATTLE WA
98115-6715
US

V. Phone/Fax

Practice location:
  • Phone: 805-948-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberOP00001813
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number20A10519
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: