MEDICARE: DAVID ALAN EHRENFELD 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	207P00000X	Emergency Medicine Physician	C32813	CA

General Provider Information

NPI Number	:	1417051830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ALAN EHRENFELD M.D.

Provider Business Mailing Address
First Line	:	5000 HOPYARD RD
Second Line	:	SUITE 100
City	:	PLEASANTON
State	:	CA
Zip	:	94583
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 B GALE WILSON BLVD
Second Line	:	STE 203
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-3700
Country	:	US
Telephone Number	:	707-429-7701
Fax Number	:

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

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	07/08/2007

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