Individual
ELISE ELEANOR HILL FANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MPP
Contact information
Practice address
3312 CHICKADEE CT, WEST SACRAMENTO, CA 95691-6450
(515) 401-2537
Mailing address
3312 CHICKADEE CT, WEST SACRAMENTO, CA 95691-6450
(515) 401-2537
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
164482
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/24/2018
Last updated
01/10/2025
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