Provider Demographics
NPI:1194732339
Name:ERSKINE, THOMAS DANIEL (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:DANIEL
Last Name:ERSKINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3390 CRYSTAL CT
Mailing Address - Street 2:STE 100
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3148
Mailing Address - Country:US
Mailing Address - Phone:707-624-7979
Mailing Address - Fax:
Practice Address - Street 1:1010 NUT TREE RD
Practice Address - Street 2:STE 100
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4172
Practice Address - Country:US
Practice Address - Phone:707-624-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63845207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G97116Medicare UPIN