Provider Demographics
NPI:1376660704
Name:GAIR, ERICKA MARIE (DO)
Entity Type:Individual
Prefix:MRS
First Name:ERICKA
Middle Name:MARIE
Last Name:GAIR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15200 W SUNSET BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3620
Mailing Address - Country:US
Mailing Address - Phone:310-459-7736
Mailing Address - Fax:310-230-0284
Practice Address - Street 1:15200 W SUNSET BLVD STE 107
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3620
Practice Address - Country:US
Practice Address - Phone:310-459-7736
Practice Address - Fax:310-230-0284
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB380834Medicaid
CA20A9980OtherCA LICENSE