Healthcare Provider Details

I. General information

NPI: 1104882067
Provider Name (Legal Business Name): ELIZABETH KOVACS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 05/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CALIFORNIA BLVD
PASADENA CA
91105-3010
US

IV. Provider business mailing address

1485 E WOODBURY RD
PASADENA CA
91104-1555
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-3826
  • Fax: 626-397-2181
Mailing address:
  • Phone: 626-397-3826
  • Fax: 626-397-2181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA40350
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA40350
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: