| Doctor Name: | DR. DOUGLAS ALAN EHRENBERG |
| NPI Number: | 1376597443 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | E3463 |
| Business Practice Address: | 52 Mohawk Ave Corte Madera, CA - 949251033 |
| Business Phone Number: | 4153857587 |
| Business Fax Number: | |
| Mailing Address: | 52 Mohawk Ave, CORTE MADERA |
| State: | CA |
| Postal Code: | 949251033 |
| Phone Number: | 4153857587 |
| Fax Number: | |
| NPI Enumeration Date: | 05/21/2006 |
| NPI Last Update Date: | 11/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0000X |
| License Number: | E3463 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Sports Medicine |
| Taxonomy Definition: | |