Provider Demographics
NPI:1730261207
Name:CHERYL L. EFFRON, M.D., INC.
Entity type:Organization
Organization Name:CHERYL L. EFFRON, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LARRAINE
Authorized Official - Last Name:EFFRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-974-3272
Mailing Address - Street 1:500 S ANAHEIM HILLS RD
Mailing Address - Street 2:STE 210
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4780
Mailing Address - Country:US
Mailing Address - Phone:714-974-3272
Mailing Address - Fax:714-974-4517
Practice Address - Street 1:500 S ANAHEIM HILLS RD
Practice Address - Street 2:STE 210
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-4780
Practice Address - Country:US
Practice Address - Phone:714-974-3272
Practice Address - Fax:714-974-4517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG034396174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG34396Medicare ID - Type Unspecified
CAA45192Medicare UPIN