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General NPI Number Information
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NPI Number | 1871626036
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Entity Type | Individual
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Provider Name | JOHN TRUMAN ELI DMD, MSD
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Gender | Male
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 40620 WINCHESTER RD SUITE B
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City | TEMECULA
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State | CA
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Zip | 92591-5504
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Country | US
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Telephone | 951-719-3182
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Fax |
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Provider Business Mailing Address
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Address Line | 26676 CARRANZA DR
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City | MISSION VIEJO
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State | CA
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Zip | 92691-4944
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Country | US
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Telephone | 949-305-9847
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 52381
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License Number State | CA
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