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ELLISON MEDICAL GROUP VEIN TREATMENT CENTER NPI 1033614706


NPI Information

NPI: 1033614706
Provider Name: ELLISON MEDICAL GROUP VEIN TREATMENT CENTER
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
5330 CARROLL CANYON RD STE 140
SAN DIEGO, CA
ZIP 92121
Phone: (858) 926-7678
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ELLISON MEDICAL GROUP VEIN TREATMENT CENTER is a specialist in San Diego, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ELLISON MEDICAL GROUP VEIN TREATMENT CENTER NPI is 1033614706. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5330 CARROLL CANYON RD STE 140
SAN DIEGO, CA
ZIP 92121-758
Phone: (858) 926-7678
Fax: (347) 405-8161

The provider's authorized official is William Schoenfeld .
The authorized official title is Owner and has the following contact phone number (858) 926-7678.

The enumeration date for this NPI number is 3/26/2018 and was last updated on 6/2/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A108285OTHERCALIFORNIALICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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