Organization
DAVID SCOTT ELAM
Active
Other names
CROSS SPEECH REHABILITATION AGENCY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID SCOTT ELAM M.A. CCC (DIRECTOR)
(805) 733-4542
Entity
Organization
Contact information
Practice address
191 BURTON MESA BLVD, #D, LOMPOC, CA 93436-1400
(805) 733-4542
(805) 733-4392
Mailing address
191 BURTON MESA BLVD, #D, LOMPOC, CA 93436-1400
(805) 733-4542
(805) 733-4392
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP5420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0663623
TRIWEST
CA
01
—
ZZZ05144Z
BLUE SHIELD
CA
Enumeration date
06/04/2007
Last updated
05/22/2012
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