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General NPI Number Information
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NPI Number | 1215937388
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Entity Type | Individual
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Provider Name | GARRETT M. ECKERLING M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 111 BANK ST STE 256
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City | GRASS VALLEY
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State | CA
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Zip | 95945-6518
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Country | US
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Telephone | 530-277-5207
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Fax | 530-432-3130
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Provider Business Mailing Address
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Address Line | 111 BANK ST STE 256
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City | GRASS VALLEY
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State | CA
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Zip | 95945-6518
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Country | US
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Telephone | 530-277-5207
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Fax | 530-432-3130
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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 | A61177
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License Number State | CA
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