Provider Demographics
NPI:1821413907
Name:IKE, ERICA LAUREN (DO)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LAUREN
Last Name:IKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18002 WIKA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2125
Mailing Address - Country:US
Mailing Address - Phone:760-946-9600
Mailing Address - Fax:918-747-9778
Practice Address - Street 1:18002 WIKA RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307
Practice Address - Country:US
Practice Address - Phone:760-946-9600
Practice Address - Fax:918-747-9778
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16603208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics