Thomas W. Ela, M.d., Inc. | |
2282 N State College Blvd Fullerton CA 92831-1362 | |
(714) 780-9770 | |
(714) 780-9773 |
Full Name | Thomas W. Ela, M.d., Inc. |
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Speciality | Psychiatry & Neurology |
Location | 2282 N State College Blvd, Fullerton, California |
Authorized Official Name and Position | Thomas W Ela (PRESIDENT / PHYSICIAN) |
Authorized Official Contact | 7147809770 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Thomas W. Ela, M.d., Inc. Po Box 2666 Seal Beach CA 90740-1666 Ph: (714) 780-9770 | Thomas W. Ela, M.d., Inc. 2282 N State College Blvd Fullerton CA 92831-1362 Ph: (714) 780-9770 |
NPI Number | 1588863716 |
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Provider Enumeration Date | 07/17/2007 |
Last Update Date | 02/26/2019 |
Medicare PECOS PAC ID | 1759325335 |
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Medicare Enrollment ID | O20050614001368 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588863716 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | G65793 (California) | Secondary |
2084N0400X | Psychiatry & Neurology - Neurology | (California) | Primary |
Provider Name | Thomas W Ela |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1831184795 PECOS PAC ID: 3678519519 Enrollment ID: I20100802000718 |
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