Provider Demographics
NPI:1679629901
Name:AUSTIN, ERIK (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 EXECUTIVE DRIVE
Mailing Address - Street 2:SUITE 227
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121
Mailing Address - Country:US
Mailing Address - Phone:858-622-1960
Mailing Address - Fax:858-622-1900
Practice Address - Street 1:4520 EXECUTIVE DRIVE
Practice Address - Street 2:SUITE 227
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121
Practice Address - Country:US
Practice Address - Phone:858-622-1960
Practice Address - Fax:858-622-1900
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9651207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology