Provider Demographics
NPI:1154661015
Name:SUGIHARA, ERIC (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SUGIHARA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 N HARBOR BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2635
Mailing Address - Country:US
Mailing Address - Phone:714-447-4100
Mailing Address - Fax:714-447-1923
Practice Address - Street 1:2240 N HARBOR BLVD STE 200
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2635
Practice Address - Country:US
Practice Address - Phone:714-447-4100
Practice Address - Fax:714-447-1923
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16389207Y00000X
WAOP60847818207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology