Provider Demographics
NPI:1083180350
Name:LANGMACK, ERIC (RADT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:LANGMACK
Suffix:
Gender:M
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20122 TRANQUIL LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-4653
Mailing Address - Country:US
Mailing Address - Phone:171-424-8190
Mailing Address - Fax:
Practice Address - Street 1:600 W SANTA ANA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4558
Practice Address - Country:US
Practice Address - Phone:714-667-7926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)