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General NPI Number Information
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NPI Number | 1205303229
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Entity Type | Individual
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Provider Name | ERICA HAEDRICH BAUER PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/29/2018
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 20641 COMMERCE WAY
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City | BURNEY
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State | CA
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Zip | 96013-4380
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Country | US
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Telephone | 530-335-6070
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Fax | 530-338-3368
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Provider Business Mailing Address
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Address Line | 44172 WALNUT ST
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City | MCARTHUR
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State | CA
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Zip | 96056-8560
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Country | US
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Telephone | 530-717-0324
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 56202
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License Number State | CA
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