Healthcare Provider Details

I. General information

NPI: 1164942397
Provider Name (Legal Business Name): IMANI ELIZABETH MCELROY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SAN PABLO ST
LOS ANGELES CA
90033-5313
US

IV. Provider business mailing address

1500 SAN PABLO ST
LOS ANGELES CA
90033-5313
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-1900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA194137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: