Ethan A Egan, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

A134845 Issued in CA

Practice address

5630 E Santa Ana Canyon Rd
Suite 150
Anaheim, CA 92807-3122

Phone

(714) 804-1000

NPI assigned

May 27, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1649405283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5630 E SANTA ANA CANYON RD",
            "address_2": "SUITE 150",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073122",
            "telephone_number": "714-804-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 E SANTA ANA CANYON RD",
            "address_2": "SUITE 150",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073122",
            "telephone_number": "714-804-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "ETHAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-27",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A134845",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "A134845",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A134845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Leanne Edwards
• William Randolph Jo Edwards, DC
• Jerome Ee
• Kristen Eelkema, M.A., CCC-SLP
• Cheryl L. Effron, M.D.
• J. Robert Egan, MD
• Heather Egenberger
• Ndidi Egeonuigwe, MS, SLP
• Steven Michaeli Egner, PT, DPT, CSCS
• Shiloh Ehlers

• Physical Medicine & Rehabilitation Physician in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.