MEDICARE: DR. JORINA MARIA ELBERS 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
1	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	A120454	CA

General Provider Information

NPI Number	:	1508132457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORINA MARIA ELBERS MD

Provider Business Mailing Address
First Line	:	740 FRONT ST STE 130
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-4536
Country	:	US
Telephone Number	:	831-400-1277
Fax Number	:	831-400-1274

Provider Business Practice Location Address
First Line	:	740 FRONT ST STE 130
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-4536
Country	:	US
Telephone Number	:	831-400-1277
Fax Number	:	831-400-1274

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

Provider Enumeration Date	:	03/26/2012
Last Update Date	:	09/05/2024

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