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Individual

DR. JACOB ELISHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
11600 WILSHIRE BLVD STE 504, LOS ANGELES, CA 90025-1788
(310) 231-5100
(310) 231-0024
Mailing address
11600 WILSHIRE BLVD STE 504, LOS ANGELES, CA 90025-1788
(310) 231-5100
(310) 231-0024

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
36239
CA

Other

Enumeration date
01/18/2012
Last updated
01/18/2012
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