Provider Demographics
NPI:1790742708
Name:ERASMUS, BINA K (MD)
Entity Type:Individual
Prefix:
First Name:BINA
Middle Name:K
Last Name:ERASMUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 MOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-4113
Mailing Address - Country:US
Mailing Address - Phone:510-794-3500
Mailing Address - Fax:510-794-2948
Practice Address - Street 1:674 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4113
Practice Address - Country:US
Practice Address - Phone:510-794-3500
Practice Address - Fax:510-794-2948
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35234207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A352340Medicaid
CAS27721Medicare UPIN
CA00A352340Medicaid