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Individual

DR. DOUGLAS ALAN EHRENBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
52 MOHAWK AVE, CORTE MADERA, CA 94925-1033
(415) 385-7587
Mailing address
52 MOHAWK AVE, CORTE MADERA, CA 94925-1033
(415) 385-7587

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3463
CA
213ES0000X
Sports Medicine Podiatrist
E3463
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
E3463
STATE LIC.
CA
Enumeration date
05/21/2006
Last updated
11/03/2008
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