Organization
TIFFANY ELIZABETH ELLIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY ELIZABETH ELLIS D.O. (PHYSICIAN)
(954) 258-0716
Entity
Organization
Contact information
Practice address
4101 TORRANCE BLVD, TORRANCE, CA 90503-4607
(310) 944-8888
Mailing address
4170 ADMIRALTY WAY, APT 316, MARINA DEL REY, CA 90292-6257
(954) 258-0716
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
20A11353
CA
Other
Enumeration date
12/22/2010
Last updated
12/22/2010
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