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Individual

DR. L. EDWARD ELLIOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1555 VIKING ST, ESCALON, CA 95320-1742
(209) 838-7263
(209) 838-8093
Mailing address
1555 VIKING ST, ESCALON, CA 95320-1742
(209) 838-7263
(209) 838-8093

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
4716T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SD0047161
CA
Enumeration date
08/19/2005
Last updated
06/21/2010
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