Basic Information
Provider Information | |||||||||
NPI: | 1508911538 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SOKOL | ||||||||
FirstName: | ERIC | ||||||||
MiddleName: | RUSSELL | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 300 PASTEUR DR | ||||||||
Address2: | ROOM HH333 | ||||||||
City: | STANFORD | ||||||||
State: | CA | ||||||||
PostalCode: | 943052200 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6507364137 | ||||||||
FaxNumber: | 6507237737 | ||||||||
Practice Location | |||||||||
Address1: | 300 PASTEUR DR | ||||||||
Address2: | ROOM HH333 | ||||||||
City: | STANFORD | ||||||||
State: | CA | ||||||||
PostalCode: | 943052200 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6507364137 | ||||||||
FaxNumber: | 6507237737 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/23/2007 | ||||||||
LastUpdateDate: | 10/25/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | A92783 | CA | N |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 207VF0040X | A92783 | CA | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery |
No ID Information.