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General NPI Number Information
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NPI Number | 1538556873
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Entity Type | Individual
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Provider Name | ELIZABETH SIBRACK M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1425 S MAIN ST
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City | WALNUT CREEK
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State | CA
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Zip | 94596
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Country | US
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Telephone | 925-295-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 780125
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City | PHILADELPHIA
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State | PA
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Zip | 19178-0125
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Country | US
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Telephone | 804-922-4844
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 161368
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 161368
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101286933
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License Number State | VA
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