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NPI Code Detail

MEDICARE: ERICA LEVACK CANALES MD

MEDICARE: ERICA LEVACK CANALES MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianEC080818MI
2207V00000XObstetrics & Gynecology Physician4301080818MI
3207V00000XObstetrics & Gynecology PhysicianC153733CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154381234
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA LEVACK CANALES MD
Provider Business Mailing Address
First Line : 901 NEVIN AVE
Second Line :
City : RICHMOND
State : CA
Zip : 94801-3143
Country : US
Telephone Number : 510-307-2051
Fax Number : 510-307-1920
Provider Business Practice Location Address
First Line : 901 NEVIN AVE
Second Line :
City : RICHMOND
State : CA
Zip : 94801-3143
Country : US
Telephone Number : 510-307-2051
Fax Number : 510-307-1920
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 12/17/2021

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