Ellison, Douglas Jules

Ellison, Douglas Jules is an individual health care provider with primary practice located at 7592 Metropolitan Dr Suite 405-407, San Diego CA 92108-4428. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Hematology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Ellison, Douglas Jules can be contacted via phone (619) 297-4900.

Contact Information

Primary practice address
7592 Metropolitan Dr Suite 405-407 San Diego CA 92108-4428
Phone: (619) 297-4900
Fax: (619) 297-5460
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X G53026 California
Allopathic & Osteopathic Physicians / Hematology 207ZH0000X G53026 California

Profile Details

NPI number 1922022029
LBN Legal business name Ellison, Douglas Jules
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Jun 20th, 2008 - about 16 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 1922022029 NPPES
California MEDICAID 00G530260

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