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General NPI Number Information
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NPI Number | 1831061431
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Entity Type | Organization
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Legal Business Name | JENNIFER A ELLICE MD PC
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1450 10TH ST STE 300
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City | SANTA MONICA
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State | CA
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Zip | 90401-2831
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Country | US
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Telephone | 310-310-8031
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Fax | 310-861-1753
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Provider Business Mailing Address
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Address Line | 1450 10TH ST STE 300
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City | SANTA MONICA
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State | CA
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Zip | 90401-2831
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Country | US
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Telephone | 310-310-8031
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Fax | 310-861-1753
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Authorized Official
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Title or Position | MD
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Name | JENNIFER ELLICE
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Credential | MD
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Telephone | 310-365-9428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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