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General NPI Number Information
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NPI Number | 1699050864
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Entity Type | Organization
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Legal Business Name | ELENA PATTERSON MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 10/19/2011
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 27200 CALAROGA AVE
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City | HAYWARD
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State | CA
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Zip | 94545-4339
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Country | US
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Telephone | 510-264-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 27200 CALAROGA AVE
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City | HAYWARD
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State | CA
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Zip | 94545-4339
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Country | US
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Telephone | 510-264-4000
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ELENA O PATTERSON
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Credential | M.D.
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Telephone | 510-264-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A64360
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License Number State | CA
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