Ellsworth, Edward L
Ellsworth, Edward L is an individual health care provider with primary practice located at 815 Pollard Rd , Los Gatos CA 95032-1438. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Ellsworth, Edward L can be contacted via phone (408) 866-4060.Contact Information
Primary practice address
815 Pollard Rd
Los Gatos CA 95032-1438
Phone: (408) 866-4060
Fax: (419) 866-5453
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | A21796 | California |
Profile Details
| NPI number | 1477547008 |
|---|---|
| LBN Legal business name | Ellsworth, Edward L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 9th, 2005 |
| Last updated | May 30th, 2014 - about 10 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 | 1477547008 | NPPES |
| California | MEDICAID | 00A217960 |
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