Provider Demographics
NPI:1114354800
Name:MELISA A. ERICK, M.D., INC.
Entity Type:Organization
Organization Name:MELISA A. ERICK, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ERICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-660-9535
Mailing Address - Street 1:PO BOX 4148
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90510-4148
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:855-885-2617
Practice Address - Street 1:4445 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4135
Practice Address - Country:US
Practice Address - Phone:951-788-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64088207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty