Healthcare Provider Details

I. General information

NPI: 1669556817
Provider Name (Legal Business Name): ELIEZER MASLIAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCSD MEDICAL CENTER 200 WEST ARBOR DRIVE M/C 8201
SAN DIEGO CA
92103-8201
US

IV. Provider business mailing address

9500 GILMAN DRIVE MAIL CODE 0624
LA JOLLA CA
92093-0624
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-5719
  • Fax: 619-543-3183
Mailing address:
  • Phone: 858-534-8992
  • Fax: 858-534-6232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberA67390
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA67390
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: