Provider Demographics
NPI:1376570960
Name:DOVICHI, ERIC AYKUT (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:AYKUT
Last Name:DOVICHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 OAK GROVE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2536
Mailing Address - Country:US
Mailing Address - Phone:925-296-7150
Mailing Address - Fax:925-296-7171
Practice Address - Street 1:2125 OAK GROVE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2536
Practice Address - Country:US
Practice Address - Phone:925-296-7150
Practice Address - Fax:925-296-7171
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA642352085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAX707XMedicare PIN
CAAX707FMedicare PIN
CAAX707HMedicare PIN
CAAX707JMedicare PIN
CAAX707MMedicare PIN
CAAX707YMedicare PIN
CA30125555Medicare PIN
CAAX707DMedicare PIN
CAAX707PMedicare PIN
CAAX707UMedicare PIN
CAH38996Medicare UPIN
CAAX707GMedicare PIN
CAAX707TMedicare PIN
CA300125547Medicare PIN
CA300125558Medicare PIN
CAAX707QMedicare PIN
CAAX707SMedicare PIN
CAAX707EMedicare PIN
CAAX707VMedicare PIN
CA00A642352Medicare PIN
CAAX707KMedicare PIN
CAAX707NMedicare PIN
CAAX707RMedicare PIN
CAAX707WMedicare PIN
CA00A642351Medicare PIN
CA00A642353Medicare PIN
CAAX707ZMedicare PIN