Provider Demographics
NPI:1992873905
Name:ERRICO, ANTHONY (DPM)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:ERRICO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 JASMINE CT
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1701
Mailing Address - Country:US
Mailing Address - Phone:650-991-2700
Mailing Address - Fax:650-991-2702
Practice Address - Street 1:101 S SAN MATEO DR
Practice Address - Street 2:STE 212
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3819
Practice Address - Country:US
Practice Address - Phone:650-342-3537
Practice Address - Fax:650-991-2702
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE1434213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E14341Medicaid
CAT10949Medicare UPIN
CA000E14341Medicaid