Healthcare Provider Details

I. General information

NPI: 1063782829
Provider Name (Legal Business Name): ELANA GELMAN N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 CAMINO DEL RIO S 203
SAN DIEGO CA
92108-3802
US

IV. Provider business mailing address

2831 CAMINO DEL RIO S SUITE 203
SAN DIEGO CA
92108-3802
US

V. Phone/Fax

Practice location:
  • Phone: 619-345-3111
  • Fax:
Mailing address:
  • Phone: 619-345-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: