Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 20A11441 | CA |
NPI | 1013283910 |
---|---|
Provider Name | Dr. Helia Eragi |
First Address | Newport Beach, CA 92657-1613 |
Second Address | Fullerton, CA 92835-3419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2012 |
Last Update Date | 26/03/2012 |