Basic Information
| Provider Information | |||||||||
| NPI: | 1477542686 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUANSING | ||||||||
| FirstName: | ERIK | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 840 TOWNSITE DR | ||||||||
| Address2: | |||||||||
| City: | VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920845566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662282236 | ||||||||
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| Practice Location | |||||||||
| Address1: | 69175 RAMON RD BLDG A | ||||||||
| Address2: | |||||||||
| City: | CATHEDRAL CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922343344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603216776 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2005 | ||||||||
| LastUpdateDate: | 05/22/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA15605 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.