Provider Demographics
NPI:1407153000
Name:STROM, HOWARD ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ERIC
Last Name:STROM
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 1:3411 LA FALDA PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-1509
Mailing Address - Country:US
Mailing Address - Phone:323-851-8988
Mailing Address - Fax:
Practice Address - Street 1:3411 LA FALDA PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1509
Practice Address - Country:US
Practice Address - Phone:323-851-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33569207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91524Medicare UPIN