# TIFFANY ELIZABETH ELLIS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053615658
- **Authorized official:** DR. TIFFANY ELIZABETH ELLIS D.O. (PHYSICIAN)
- **Authorized official phone:** (954) 258-0716

## Contact information

- **Practice address:** 4101 TORRANCE BLVD, TORRANCE, CA 90503-4607
- **Practice address phone:** (310) 944-8888
- **Mailing address:** 4170 ADMIRALTY WAY, APT 316, MARINA DEL REY, CA 90292-6257
- **Mailing address phone:** (954) 258-0716

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | 20A11353 | CA | Yes |

## Other

- **Enumeration date:** 12/22/2010
- **Last updated:** 12/22/2010