Elliott, L. Edward

Elliott, L. Edward is an individual health care provider with primary practice located at 1555 Viking St , Escalon CA 95320-1742. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Elliott, L. Edward can be contacted via phone (209) 838-7263.

Contact Information

Primary practice address
1555 Viking St Escalon CA 95320-1742
Phone: (209) 838-7263
Fax: (209) 838-8093
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 4716T California

Profile Details

NPI number 1023000502
LBN Legal business name Elliott, L. Edward
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Jun 21st, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023000502 NPPES
California MEDICAID SD0047161

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