Healthcare Provider Details

I. General information

NPI: 1891665014
Provider Name (Legal Business Name): ELI MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18372 CLARK ST STE 208
TARZANA CA
91356-3552
US

IV. Provider business mailing address

269 S BEVERLY DR # 904
BEVERLY HILLS CA
90212-3851
US

V. Phone/Fax

Practice location:
  • Phone: 818-632-8876
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW ELI
Title or Position: FAMILY MEDICINE PHYSICIAN
Credential: D.O.
Phone: 818-632-8876