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NPI Code Detail

MEDICARE: DR. DOUGLAS ERIC GARRISON DO

MEDICARE: DR. DOUGLAS ERIC GARRISON DO
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
1207Q00000XFamily Medicine Physician20A6292CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080175928OTHERRAILROAD MEDICARE #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386649044
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS ERIC GARRISON DO
Provider Business Mailing Address
First Line : PO BOX 25
Second Line :
City : SUNSET BEACH
State : CA
Zip : 90742-0025
Country : US
Telephone Number : 714-316-0611
Fax Number : 714-520-0087
Provider Business Practice Location Address
First Line : 4911 WARNER AVE STE 205
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92649-4473
Country : US
Telephone Number : 714-316-0611
Fax Number : 714-520-0087
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 04/20/2021

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