Provider Demographics
NPI:1003027806
Name:MICHAEL G MYERS MD AND ERIC TREFELNER MD INC
Entity type:Organization
Organization Name:MICHAEL G MYERS MD AND ERIC TREFELNER MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:TREFELNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-318-8900
Mailing Address - Street 1:1475 WOODBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3712
Mailing Address - Country:US
Mailing Address - Phone:888-318-8900
Mailing Address - Fax:650-345-5465
Practice Address - Street 1:1475 WOODBERRY AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-3712
Practice Address - Country:US
Practice Address - Phone:888-318-8900
Practice Address - Fax:650-345-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG683492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty