Provider Demographics
NPI:1144649682
Name:ERIK LUNDQUIST MD INC
Entity type:Organization
Organization Name:ERIK LUNDQUIST MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:JON
Authorized Official - Last Name:LUNDQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-234-4246
Mailing Address - Street 1:27450 YNEZ RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-4671
Mailing Address - Country:US
Mailing Address - Phone:951-383-4333
Mailing Address - Fax:951-506-2361
Practice Address - Street 1:27450 YNEZ RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4671
Practice Address - Country:US
Practice Address - Phone:951-383-4333
Practice Address - Fax:951-506-2361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty