Provider Demographics
NPI:1639941024
Name:ERB, JEFFREY G (NMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:G
Last Name:ERB
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 E 15TH ST APT H
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-5367
Mailing Address - Country:US
Mailing Address - Phone:541-913-4394
Mailing Address - Fax:
Practice Address - Street 1:1783 FLIGHT WAY
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1838
Practice Address - Country:US
Practice Address - Phone:949-722-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1464175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath