Basic Information
| Provider Information | |||||||||
| NPI: | 1376670976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MATHES | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | FORD-DIRKS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ERIN MATHES | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FORD-DIRKS | ||||||||
| OtherFirstName: | ERIN | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1701 DIVISADERO ST | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153537800 | ||||||||
| FaxNumber: | 4153537870 | ||||||||
| Practice Location | |||||||||
| Address1: | 1701 DIVISADERO ST | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153537800 | ||||||||
| FaxNumber: | 4153537870 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 03/29/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | A94786 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology | 208000000X | A94786 | CA | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.