Individual
DR. ERIC MARTIN MOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
147 N BRENT SREET, VENTURA, CA 93003
(805) 652-5011
(805) 585-3007
Mailing address
960 PENINSULA ST, VENTURA, CA 93001-3954
(805) 652-5018
(805) 650-0474
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
G68497
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050394
BLUE CROSS
CA
01
—
G68497
LICENSE NUMBER
CA
05
—
HSC30394F
—
CA
05
—
ZZT40394F
—
CA
01
—
ZZZ53994Z
BLUE SHIELD
CA
01
—
ZZZA56032
BLUE SHIELD
CA
Enumeration date
10/02/2006
Last updated
07/09/2007
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