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General NPI Number Information
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NPI Number | 1053389205
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Entity Type | Individual
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Provider Name | ERIC R MARIOTTI MD
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 03/14/2014
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Provider Practice Location Address
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Address Line | 2222 EAST ST #310
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City | CONCORD
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State | CA
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Zip | 94520-2084
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Country | US
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Telephone | 925-685-4533
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Fax | 952-685-0665
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Provider Business Mailing Address
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Address Line | 2222 EAST ST #310
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City | CONCORD
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State | CA
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Zip | 94520-2084
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Country | US
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Telephone | 925-685-4533
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Fax | 952-685-0665
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | G85332
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License Number State | CA
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