Basic Information
Provider Information
NPI: 1780651893
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EHRREICH
FirstName: STEVEN
MiddleName: T.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 9300 VALLEY CHILDRENS PL
Address2:  
City: MADERA
State: CA
PostalCode: 936388761
CountryCode: US
TelephoneNumber: 5593536215
FaxNumber: 5593536222
Practice Location
Address1: 9300 VALLEY CHILDRENS PL
Address2:  
City: MADERA
State: CA
PostalCode: 936388761
CountryCode: US
TelephoneNumber: 5593536215
FaxNumber: 5593536222
Other Information
ProviderEnumerationDate: 03/07/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: X
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XG85628CAX Allopathic & Osteopathic PhysiciansPediatrics 
2084N0402XG85628CAX Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology

No ID Information.


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