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General NPI Number Information
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NPI Number | 1033484068
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Entity Type | Individual
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Provider Name | MR. ERIK ERNEST COURTER
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Gender | Male
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 4000 BIRCH ST STE 120
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2258
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Country | US
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Telephone | 949-642-8057
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 PLACENTIA AVE SPC F6
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-2825
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Country | US
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Telephone | 714-356-9274
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 29726
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License Number State | CA
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