Earlyn Cunanan Noll, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

200893 Issued in LA

Practice address

132 E St
Suite 220
Davis, CA 95616-4649

Phone

(530) 756-5758

Fax

(530) 756-5753

NPI assigned

Apr 1, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Earlyn Villaroman Cunanan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 15, 2016 through Jun 15, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319241600000",
    "number": "1801068648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E ST",
            "address_2": "SUITE 220",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164649",
            "telephone_number": "530-756-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E ST",
            "address_2": "SUITE 220",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164649",
            "telephone_number": "530-756-5758",
            "fax_number": "530-756-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLL",
        "first_name": "EARLYN",
        "middle_name": "CUNANAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2011-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "200893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EARLYN",
            "last_name": "CUNANAN",
            "middle_name": "VILLAROMAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dermatology Physician in Davis, CA
• Providers in Davis, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.