Individual
EROL DECULING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
501 S BROOKHURST RD, FULLERTON, CA 92833-3207
(209) 872-4323
Mailing address
600 WALNUT WOODS CT, MODESTO, CA 95356-9656
(209) 872-4323
(888) 879-5356
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95000556
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95000556
LICENSE NUMBER
CA
Enumeration date
04/09/2014
Last updated
04/17/2020
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