Provider Demographics
NPI:1801268263
Name:SCHOLANDER, ERIC CARL (SFIDC)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:CARL
Last Name:SCHOLANDER
Suffix:
Gender:M
Credentials:SFIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6634 ANTIGUA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-4012
Mailing Address - Country:US
Mailing Address - Phone:970-560-0570
Mailing Address - Fax:
Practice Address - Street 1:6634 ANTIGUA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-4012
Practice Address - Country:US
Practice Address - Phone:970-560-0570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman