Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 33280 | CA |
Y | 1223P0300X | Periodontist | 33280 | CA |
NPI | 1215038377 |
---|---|
Provider Name | Dr. Jean-Jacques Elbaz |
First Address | Beverly Hills, CA 90212-2614 |
Second Address | Beverly Hills, CA 90212-2602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 10/06/2021 |