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General NPI Number Information
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NPI Number | 1881830883
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Entity Type | Individual
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Provider Name | ERUM ANSARI MD
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Gender | Female
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Dates
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Enumeration Date | 12/21/2008
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 200 PORTER DR STE 300
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City | SAN RAMON
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State | CA
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Zip | 94583-1524
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Country | US
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Telephone | 925-838-6511
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Fax |
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Provider Business Mailing Address
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Address Line | 1450 TREAT BLVD STE 300
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2168
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Country | US
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Telephone | 925-952-2888
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Fax | 925-275-0488
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A 102069
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License Number State | CA
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