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NPI Code Detail

MEDICARE: ELLIOTT LUPIN

MEDICARE: ELLIOTT LUPIN
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1851245146
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIOTT LUPIN
Provider Business Mailing Address
First Line : 9600 CENTER AVE STE 160
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-5838
Country : US
Telephone Number : 858-264-5858
Fax Number : 858-264-5858
Provider Business Practice Location Address
First Line : 9600 CENTER AVE STE 160
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-5838
Country : US
Telephone Number : 858-264-5858
Fax Number : 858-264-5858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2026
Last Update Date : 02/24/2026

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Directions to “ ELLIOTT LUPIN ” Practice Location

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