Individual
BRIAN EUGENE ELLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
461 TENNESSEE ST STE C, REDLANDS, CA 92373-8161
(909) 475-7371
Mailing address
PO BOX 742353, ATLANTA, GA 30374-2353
(310) 482-8403
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
20A14904
CA
2084P0800X
Psychiatry Physician
Primary
9848744-1204
UT
Other
Enumeration date
03/25/2013
Last updated
05/13/2026
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