Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 1194262 | TX |
N | 225100000X | Physical Therapist | PTH5836 | AL |
Y | 2251X0800X | Physical Therapist - Orthopedic | 39517 | CA |
NPI | 1043541170 |
---|---|
Provider Name | Dr. Jonathan Michael Elbert |
First Address | Rancho Mirage, CA 92270-2001 |
Second Address | Indio, CA 92201-1876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2010 |
Last Update Date | 11/08/2016 |