Provider Demographics
NPI:1861016883
Name:HOLMGREN, ERIC ROBERT (RT(R)(CT)(ARRT))
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ROBERT
Last Name:HOLMGREN
Suffix:
Gender:M
Credentials:RT(R)(CT)(ARRT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 DUBOCE AVE
Mailing Address - Street 2:NORTH TOWER, LEVEL A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114
Mailing Address - Country:US
Mailing Address - Phone:415-600-6180
Mailing Address - Fax:
Practice Address - Street 1:601 DUBOCE AVE
Practice Address - Street 2:NORTH TOWER, LEVEL A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114
Practice Address - Country:US
Practice Address - Phone:415-600-6180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHF001046352471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography