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Individual

MR. IAN SPENCER ELARIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
27700 MEDICAL CENTER RD, MISSION VIEJO, CA 92691-6426
(949) 345-0805
Mailing address
PO BOX 27352, SANTA ANA, CA 92799-7352
(949) 345-0805

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E158410
CA
390200000X
Student in an Organized Health Care Education/Training Program
CA

Other

Enumeration date
09/21/2020
Last updated
07/22/2022
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