Individual
ELIE JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 MEDICAL PLAZA DR STE 190, ROSEVILLE, CA 95661-2867
(916) 679-3590
(916) 786-7498
Mailing address
1300 ETHAN WAY STE 600, SACRAMENTO, CA 95825-2296
(916) 482-7623
(916) 482-3647
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A168259
CA
Other
Enumeration date
06/24/2016
Last updated
07/17/2023
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