Individual
LARRY L ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1409 E BRIGGSMORE AVE, MODESTO, CA 95355-2707
(209) 550-4720
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C34164
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C341640
—
CA
Enumeration date
06/22/2006
Last updated
06/11/2010
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