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General NPI Number Information
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NPI Number | 1780855734
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Entity Type | Organization
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Legal Business Name | ELENA R. REGALA, M.D., INC.
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 210 S PALISADE DR STE 202
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City | SANTA MARIA
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State | CA
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Zip | 93454-8900
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Country | US
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Telephone | 805-922-8429
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Fax | 805-349-9389
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Provider Business Mailing Address
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Address Line | 210 S PALISADE DR STE 202
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City | SANTA MARIA
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State | CA
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Zip | 93454-8900
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Country | US
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Telephone | 805-922-8429
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Fax | 805-349-9389
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | ELENA R REGALA
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Credential | M.D.
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Telephone | 805-922-8429
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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 | A-336760
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License Number State | CA
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