MEDICARE: MR. MILTON KARL ERMAN 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	174400000X	Specialist	G57278	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DD511Y	OTHER	CA	INDIVIDUAL PTAN LOS ANGELES

General Provider Information

NPI Number	:	1619993490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MILTON KARL ERMAN M.D.

Provider Business Mailing Address
First Line	:	6725 MESA RIDGE RD
Second Line	:	SUITE 224
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-2925
Country	:	US
Telephone Number	:	858-224-1855
Fax Number	:	858-224-1856

Provider Business Practice Location Address
First Line	:	6725 MESA RIDGE RD
Second Line	:	SUITE 224
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-2925
Country	:	US
Telephone Number	:	858-224-1855
Fax Number	:	858-224-1856

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	04/13/2012

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