Provider Demographics
NPI:1215367792
Name:SICKINGER, ERIC (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:SICKINGER
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 1:41990 COOK ST STE F1006
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6100
Mailing Address - Country:US
Mailing Address - Phone:760-636-1067
Mailing Address - Fax:855-523-0512
Practice Address - Street 1:665 CAMINO DE LOS MARES STE 305
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2841
Practice Address - Country:US
Practice Address - Phone:949-388-1060
Practice Address - Fax:855-523-0512
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A13043204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine