Provider Demographics
NPI:1780889873
Name:PIETZSCH, ERIKA S (MD)
Entity type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:S
Last Name:PIETZSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:STUCKERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4442 SPECTRUM
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3384
Mailing Address - Country:US
Mailing Address - Phone:215-384-3332
Mailing Address - Fax:
Practice Address - Street 1:3460 E LA PALMA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-2020
Practice Address - Country:US
Practice Address - Phone:714-644-2270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102725174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist