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General NPI Number Information
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NPI Number | 1558355040
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Entity Type | Individual
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Provider Name | ELLIOTT J CAINE O.D
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 5016 YORK BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90042-1714
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Country | US
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Telephone | 626-403-9810
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Fax | 626-403-4597
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Provider Business Mailing Address
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Address Line | 5016 YORK BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90042-1714
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Country | US
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Telephone | 626-403-9810
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Fax | 626-403-4597
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT6005T
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License Number State | CA
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