Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G26094 | CA |
Y | 208600000X | Surgeon | G26094 | CA |
NPI | 1003961939 |
---|---|
Provider Name | Dr. Elliot David Prager |
First Address | Santa Barbara, CA 93108-1825 |
Second Address | Santa Barbara, CA 93108-1825 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |