Organization
SIX IMPOSSIBLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ELLICE (MD)
(310) 310-8031
Entity
Organization
Contact information
Practice address
1450 10TH ST STE 300, SANTA MONICA, CA 90401-2831
(310) 310-8031
Mailing address
1450 10TH ST STE 300, SANTA MONICA, CA 90401-2831
(310) 310-8031
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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