| Doctor Name: | ERIC BELLFORT |
| NPI Number: | 1073504403 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA14504 |
| Business Practice Address: | 20103 Lake Chabot Rd Castro Valley, CA - 945465341 |
| Business Phone Number: | 2093422300 |
| Business Fax Number: | 2095244240 |
| Mailing Address: | 4301 Northstar Way, MODESTO |
| State: | CA |
| Postal Code: | 953569262 |
| Phone Number: | 2093422300 |
| Fax Number: | 2095244240 |
| NPI Enumeration Date: | 11/03/2005 |
| NPI Last Update Date: | 07/20/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SE0003X |
| License Number: | PA14504 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Emergency |
| Taxonomy Definition: | |