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General NPI Number Information
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NPI Number | 1275248403
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Entity Type | Individual
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Provider Name | ELI RAINIER LIPSCOMB FNP
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Gender | Male
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 4002 VISTA WAY
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City | OCEANSIDE
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State | CA
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Zip | 92056-4506
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Country | US
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Telephone | 760-940-7701
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Fax |
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Provider Business Mailing Address
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Address Line | 304 N RIOS AVE
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1242
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Country | US
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Telephone | 858-204-5792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95020598
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License Number State | CA
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