Individual
GRACE S ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2615
(951) 782-3796
(951) 784-3263
Mailing address
3660 ARLINGTON AVE, RIVERSIDE, CA 92506-3912
(951) 782-3796
(951) 784-3263
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
G45811
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ31887Z
GROUP PTAN
CA
Enumeration date
01/03/2006
Last updated
12/02/2011
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