Active NPI
Joel S. Erickson, M.D., Inc.
Doing business as Laser Light Treatment Center
- Cardiovascular Disease Physician
- Novato, CA
National Provider Identifier
1326392168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- G54218
- Legal business name
- JOEL S. ERICKSON, M.D., INC.
- Doing business as
- Laser Light Treatment Center
- Practice address
- 165 Rowland Way Ste 212
Novato, CA 94945-5055 - Phone
- (415) 892-9550
- NPI assigned
- Nov 1, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Joel S. Erickson, M.D.
- Title
- President
- Phone
- (415) 892-9550
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | G54218 | CA | Primary |
Addresses
Primary practice location
165 Rowland Way Ste 212
Novato, CA 94945-5055
Mailing address
165 Rowland Way Ste 212
Novato, CA 94945-5055
Phone (415) 892-9550
Other names 1
- Laser Light Treatment Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
165 Rowland Way
Ste 212
Novato, CA 94945
Phone (415) 892-9550
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Santa Rosa, CA
- NPI 1407899479
-
- Adult Health Nurse Practitioner
- Santa Rosa, CA
- NPI 1689797029
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351728000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1351728000000",
"number": "1326392168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 ROWLAND WAY STE 212",
"city": "NOVATO",
"state": "CA",
"postal_code": "949455055",
"telephone_number": "415-892-9550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 ROWLAND WAY STE 212",
"city": "NOVATO",
"state": "CA",
"postal_code": "949455055",
"telephone_number": "415-892-9550"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOEL S. ERICKSON, M.D., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2012-11-01",
"last_updated": "2012-11-01",
"status": "A",
"authorized_official_last_name": "ERICKSON",
"authorized_official_first_name": "JOEL",
"authorized_official_middle_name": "S.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "415-892-9550",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "G54218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Laser Light Treatment Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Novato, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.