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NPI 1114354800

NPI 1114354800 : MELISA A. ERICK, M.D., INC. : RIVERSIDE, CA

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General NPI Number Information
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    NPI Number           |    1114354800
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    Entity Type          |    Organization 
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    Legal Business Name  |    MELISA A. ERICK, M.D., INC. 
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Dates
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    Enumeration Date     |    09/26/2013
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    Last Update Date     |    04/05/2017
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Provider Practice Location Address
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    Address Line         |    4445 MAGNOLIA AVE 
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    City                 |    RIVERSIDE
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    State                |    CA
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    Zip                  |    92501-4135
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    Country              |    US
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    Telephone            |    951-788-3000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 4148 
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    City                 |    TORRANCE
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    State                |    CA
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    Zip                  |    90510-4148
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    Country              |    US
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    Telephone            |    310-792-3914
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    Fax                  |    855-885-2617
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     MELISA A ERICK 
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    Credential           |    M.D.
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    Telephone            |    951-660-9535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    G64088
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    License Number State |    CA
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