Washington, Eleby Rudolph

Washington, Eleby Rudolph is an individual health care provider with primary practice located at 4644 Lincoln Blvd Suite 101, Marina Del Rey CA 90292-6313. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Washington, Eleby Rudolph can be contacted via phone (310) 577-8500.

Contact Information

Primary practice address
4644 Lincoln Blvd Suite 101 Marina Del Rey CA 90292-6313
Phone: (310) 577-8500
Fax: (310) 577-8507
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X G53301 California

Profile Details

NPI number 1154315273
LBN Legal business name Washington, Eleby Rudolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Jul 8th, 2007 - about 17 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 1154315273 NPPES
California MEDICAID 00G533010

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