Provider Demographics
NPI:1730583063
Name:APELAND, ERRIC LEIF (IDC)
Entity type:Individual
Prefix:
First Name:ERRIC
Middle Name:LEIF
Last Name:APELAND
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8107 DELTA ST APT B
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-8625
Mailing Address - Country:US
Mailing Address - Phone:757-646-0213
Mailing Address - Fax:
Practice Address - Street 1:1436 THIRD STREET
Practice Address - Street 2:MCAGCC
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278
Practice Address - Country:US
Practice Address - Phone:460-830-5929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman