Basic Information
| Provider Information | |||||||||
| NPI: | 1043503295 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAO | ||||||||
| FirstName: | ERIC | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3160 FOLSOM BLVD STE 3500 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167348616 | ||||||||
| FaxNumber: | 9164512024 | ||||||||
| Practice Location | |||||||||
| Address1: | 3160 FOLSOM BLVD STE 3500 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167348616 | ||||||||
| FaxNumber: | 9164512024 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2011 | ||||||||
| LastUpdateDate: | 01/31/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | A147641 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | MD14655 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.