Healthcare Provider Details

I. General information

NPI: 1689611923
Provider Name (Legal Business Name): ELMA ABAD-PELSANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 AMERICA WAY
DEL MAR CA
92014-3916
US

IV. Provider business mailing address

847 AMERICA WAY
DEL MAR CA
92014-3916
US

V. Phone/Fax

Practice location:
  • Phone: 858-999-7089
  • Fax:
Mailing address:
  • Phone: 858-999-7089
  • Fax: 706-434-8876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA46584
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: