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General NPI Number Information
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NPI Number | 1285917120
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Entity Type | Organization
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Legal Business Name | ERDIRECT
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 6114 LA SALLE AVE SUITE 741
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City | OAKLAND
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State | CA
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Zip | 94611-2802
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Country | US
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Telephone | 800-756-4206
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Fax |
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Provider Business Mailing Address
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Address Line | 6114 LA SALLE AVE SUITE 741
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City | OAKLAND
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State | CA
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Zip | 94611-2802
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SEAN EDWARD PARKIN
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Credential | PA-C
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Telephone | 415-671-9615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | A104178
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License Number State | CA
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