Provider Demographics
NPI:1124247176
Name:FLEISCHAUER, ERICA L (MS, MPT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:FLEISCHAUER
Suffix:
Gender:F
Credentials:MS, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 SKYPARK DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4753
Mailing Address - Country:US
Mailing Address - Phone:310-791-4980
Mailing Address - Fax:310-791-4989
Practice Address - Street 1:3701 SKYPARK DR
Practice Address - Street 2:SUITE 260
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4753
Practice Address - Country:US
Practice Address - Phone:310-791-4980
Practice Address - Fax:310-791-4989
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 23380174400000X
CAPT23380225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB261433Medicare PIN