Travis, Eric
Travis, Eric is an individual health care provider with primary practice located at 18800 Main St Suite 104, Huntington Beach CA 92648-1707. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Travis, Eric can be contacted via phone (714) 841-1963.Contact Information
Primary practice address
18800 Main St Suite 104
Huntington Beach CA 92648-1707
Phone: (714) 841-1963
Fax: (714) 841-6919
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | E4459 | California |
Profile Details
| NPI number | 1104926070 |
|---|---|
| LBN Legal business name | Travis, Eric |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104926070 | NPPES |
| California | Other | 000E44590 | B/S OF CAL-INDIVIDUAL ID |
| California | Other | 73-1649799 | B/S OF CAL-INDIVIDUAL ID |
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