Provider Demographics
NPI:1558394080
Name:EREMIA, SORIN (MD)
Entity Type:Individual
Prefix:
First Name:SORIN
Middle Name:
Last Name:EREMIA
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 1:4440 BROCKTON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-4068
Mailing Address - Country:US
Mailing Address - Phone:951-275-0988
Mailing Address - Fax:951-275-9223
Practice Address - Street 1:4440 BROCKTON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4068
Practice Address - Country:US
Practice Address - Phone:951-275-0988
Practice Address - Fax:951-275-9223
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42033207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0685074OtherCLEA
CA070002290OtherRAILROAD MEDICARE
CA070002290OtherRAILROAD MEDICARE
CA05D0685074OtherCLEA
CA070002290OtherRAILROAD MEDICARE
CA00G420330Medicare ID - Type Unspecified