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NPI Code Detail

MEDICARE: ELAZAR SOFER MD

MEDICARE: ELAZAR SOFER MD
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
1207YS0123XFacial Plastic Surgery PhysicianA127445CA

General Provider Information

NPI Number : 1205124815
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELAZAR SOFER MD
Provider Business Mailing Address
First Line : 120 S SPALDING DR STE 300
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90212-1837
Country : US
Telephone Number : 310-555-5496
Fax Number :
Provider Business Practice Location Address
First Line : 8929 WILSHIRE BLVD STE 102
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90211-1950
Country : US
Telephone Number : 310-447-8502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2011
Last Update Date : 06/25/2026

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