Individual
DR. ELIOT RICHARD IVANHOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2926 SANTA MONICA BLVD, SANTA MONICA, CA 90404
(310) 828-5220
(310) 459-8353
Mailing address
16401 AKRON ST, PACIFIC PALISADES, CA 90272
(310) 828-5220
(310) 459-8353
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
G52332
CA
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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