Organization
ELNEL, INC. A CALIFORNIA CORPORATION TOTAL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARYLIZA JAZMIN PRADO (PRESIDENT/EXECUTIVE DIRECTOR)
(619) 422-0404
Entity
Organization
Contact information
Practice address
311 BROADWAY, CHULA VISTA, CA 91910-3501
(619) 422-0404
(619) 422-4153
Mailing address
311 BROADWAY, CHULA VISTA, CA 91910-3501
(619) 422-0404
(619) 422-4153
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102092900
USDOL
CA
01
—
ZZZ64637Z
BLUE SHIELD
CA
Enumeration date
06/01/2006
Last updated
08/16/2023
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