Healthcare Provider Details

I. General information

NPI: 1467454835
Provider Name (Legal Business Name): ELIAS ALBERT TARAKJI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 E SANTA CLARA ST STE 203
ARCADIA CA
91006-7232
US

IV. Provider business mailing address

488 E SANTA CLARA ST STE 203
ARCADIA CA
91006-7232
US

V. Phone/Fax

Practice location:
  • Phone: 626-359-3330
  • Fax: 844-406-5406
Mailing address:
  • Phone: 626-359-3330
  • Fax: 626-359-3339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA61002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: