Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | A127445 | CA |
NPI | 1205124815 |
---|---|
Provider Name | Elazar Sofer |
First Address | Torrance, CA 90502-2004 |
Second Address | Beverly Hills, CA 90211-1953 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2011 |
Last Update Date | 06/08/2019 |