Provider Demographics
NPI:1215052931
Name:ERMSHAR, CLIFFORD LEE (MD)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:LEE
Last Name:ERMSHAR
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 1:18080 BEACH BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1342
Mailing Address - Country:US
Mailing Address - Phone:714-442-0586
Mailing Address - Fax:
Practice Address - Street 1:18080 BEACH BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1342
Practice Address - Country:US
Practice Address - Phone:714-442-0586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48773207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology