Dr. Jacob Elisha
Periodontist
11600 Wilshire Blvd Ste 504
Los Angeles
, California 90025-1788
Dr. Jacob Elisha
Periodontist
11600 Wilshire Blvd Ste 504
Los Angeles
, California 90025-1788
(310) 231-0024
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Jacob Elisha
- 11600 Wilshire Blvd Ste 504
- Los Angeles, CA
- Zip : 90025-1788
- Fax : (310) 231-0024
- Phone : (310) 231-5100
Second Address
- Dr. Jacob Elisha
- 11600 Wilshire Blvd Ste 504
- Los Angeles, CA
- Zip : 90025-1788
- Fax : (310) 231-0024
- Phone : (310) 231-5100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 36239 | CA |
National Provider Identifier
| NPI | 1144591462 |
|---|---|
| Provider Name | Dr. Jacob Elisha |
| First Address | Los Angeles, CA 90025-1788 |
| Second Address | Los Angeles, CA 90025-1788 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/01/2012 |
| Last Update Date | 18/01/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.