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Individual
DR. ETHAN A EGAN
Active
Individual
DR. ETHAN A EGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A134845
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
A134845
CA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
A134845
CA
Other
Enumeration date
05/27/2009
Last updated
09/10/2015
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