Organization
ELLIOT RYAN CARLISLE MD INC
Active
Organization
ELLIOT RYAN CARLISLE MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIOT RYAN CARLISLE MD (OWNER AND SURGEON)
(818) 986-0200
Entity
Organization
Contact information
Practice address
17525 VENTURA BLVD STE 203, ENCINO, CA 91316-5109
(310) 986-0200
(818) 986-4390
Mailing address
17525 VENTURA BLVD STE 203, ENCINO, CA 91316-5109
(310) 986-0200
(818) 986-4390
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A74780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669453676
TYPE 1 NPI
CA
01
—
A74780
STATE LICENSE
CA
Enumeration date
05/08/2008
Last updated
05/08/2008
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