Healthcare Provider Details

I. General information

NPI: 1922719939
Provider Name (Legal Business Name): ELINOR VERA GREENWALD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2262 CAMINO RAMON # 200
SAN RAMON CA
94583-1353
US

IV. Provider business mailing address

2262 CAMINO RAMON # 200
SAN RAMON CA
94583-1353
US

V. Phone/Fax

Practice location:
  • Phone: 925-328-0255
  • Fax: 866-230-3553
Mailing address:
  • Phone: 925-328-0255
  • Fax: 866-230-3553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: