Dr. Douglas Alan Ehrenberg
Podiatrist Sports Medicine
52 Mohawk Ave
Corte Madera
, California 94925-1033
Dr. Douglas Alan Ehrenberg
Podiatrist Sports Medicine
52 Mohawk Ave
Corte Madera
, California 94925-1033
(415) 385-7587
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About
Features
Specialties
- Podiatrist
- Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Douglas Alan Ehrenberg
- 52 Mohawk Ave
- Corte Madera, CA
- Zip : 94925-1033
- Phone : (415) 385-7587
Second Address
- Dr. Douglas Alan Ehrenberg
- 52 Mohawk Ave
- Corte Madera, CA
- Zip : 94925-1033
- Phone : (415) 385-7587
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Is Dr. Douglas Alan Ehrenberg a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | E3463 | CA |
| Y | 222Z00000X | Podiatrist | E3463 | CA |
| N | 2081S0010X | Sports Medicine | E3463 | CA |
| N | 213ES0000X | Sports Medicine | E3463 | CA |
National Provider Identifier
| NPI | 1376597443 |
|---|---|
| Provider Name | Dr. Douglas Alan Ehrenberg |
| First Address | Corte Madera, CA 94925-1033 |
| Second Address | Corte Madera, CA 94925-1033 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/05/2006 |
| Last Update Date | 03/11/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| E3463 | STATE LIC. (01) | CA |
| T11698 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.