Healthcare Provider Details

I. General information

NPI: 1154401297
Provider Name (Legal Business Name): ALAN N ELIAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16100 SAND CANYON AVE SUITE 260
IRVINE CA
92618-3716
US

IV. Provider business mailing address

16100 SAND CANYON AVE SUITE 260
IRVINE CA
92618-3716
US

V. Phone/Fax

Practice location:
  • Phone: 949-387-0448
  • Fax: 949-387-3051
Mailing address:
  • Phone: 949-387-0448
  • Fax: 949-387-3051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number000000A30358
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: