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NPI Code Detail

MEDICARE: CAROL ROGERS ELLIOTT

MEDICARE: CAROL ROGERS ELLIOTT
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
1171100000XAcupuncturistAC3278CA

General Provider Information

NPI Number : 1396822524
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL ROGERS ELLIOTT
Provider Business Mailing Address
First Line : 1648 32ND ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-1608
Country : US
Telephone Number : 619-233-3957
Fax Number :
Provider Business Practice Location Address
First Line : 3320 2ND AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-5612
Country : US
Telephone Number : 619-294-8985
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ CAROL ROGERS ELLIOTT ” Practice Location

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