Provider Demographics
NPI:1902014376
Name:MICHAEL A ERLICH MD INC
Entity Type:Organization
Organization Name:MICHAEL A ERLICH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT MICHAEL A ERLICH MD INC
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DREW
Authorized Official - Last Name:NEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-633-1007
Mailing Address - Street 1:3650 E SOUTH STREET
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-1533
Mailing Address - Country:US
Mailing Address - Phone:562-633-1007
Mailing Address - Fax:562-633-6427
Practice Address - Street 1:3650 E SOUTH STREET
Practice Address - Street 2:SUITE 108
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-1533
Practice Address - Country:US
Practice Address - Phone:562-633-1007
Practice Address - Fax:562-633-6427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG238882084N0400X
CAG244282084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherFED TAX ID