MEDICARE: DR. DEBRA SHERYL ECHT M.D.

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
1	207R00000X	Internal Medicine Physician	G42032	CA
2	207RC0000X	Cardiovascular Disease Physician	G42032	CA
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	G42032	CA

General Provider Information

NPI Number	:	1346675766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA SHERYL ECHT M.D.

Provider Business Mailing Address
First Line	:	2145A PARADISE DR
Second Line	:
City	:	BELVEDERE TIBURON
State	:	CA
Zip	:	94920-1939
Country	:	US
Telephone Number	:	415-889-5439
Fax Number	:

Provider Business Practice Location Address
First Line	:	2145A PARADISE DR
Second Line	:
City	:	BELVEDERE TIBURON
State	:	CA
Zip	:	94920-1939
Country	:	US
Telephone Number	:	415-889-5439
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	01/04/2019

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