Ellinwood, Jeanine M
Ellinwood, Jeanine M is an individual health care provider with primary practice located at 6520 Pleasant Valley Rd , Diamond Springs CA 95619-9512. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Ellinwood, Jeanine M can be contacted via phone (530) 621-7820.Contact Information
Primary practice address
6520 Pleasant Valley Rd
Diamond Springs CA 95619-9512
Phone: (530) 621-7820
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G80715 | California |
Profile Details
| NPI number | 1790782902 |
|---|---|
| LBN Legal business name | Ellinwood, Jeanine M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2005 |
| Last updated | Nov 23rd, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790782902 | NPPES |
| California | Other | 110131834 | RAILROAD MEDICARE |
| California | Other | C006 | RAILROAD MEDICARE |
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