MEDICARE: ELAINE ZOBERMAN-SALTIEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	G87780	CA
2	207N00000X	Dermatology Physician	147173	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07015	OTHER	NY	MVP
2	32E5610	OTHER	NY	EMPIRE
3	10002241	OTHER	NY	CDPHP

General Provider Information

NPI Number	:	1083614986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE ZOBERMAN-SALTIEL M.D.

Provider Business Mailing Address
First Line	:	3401 S HARBOR BLVD
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-7933
Country	:	US
Telephone Number	:	888-988-2800
Fax Number	:	714-427-7969

Provider Business Practice Location Address
First Line	:	3401 S HARBOR BLVD
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-7933
Country	:	US
Telephone Number	:	888-988-2800
Fax Number	:	714-427-7969

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/13/2007

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