Organization
RITA R ELLITHORPE MD, INC
Active
Other names
Tustin Longevity Center
Organization subpart
No
Provider details
NPI number
Authorized official
TALON ELLITHORPE CMPE (PRACTICE MANAGER)
(714) 805-6173
Entity
Organization
Contact information
Practice address
13422 NEWPORT AVE STE L, TUSTIN, CA 92780-3746
(714) 544-1521
(888) 415-3257
Mailing address
13422 NEWPORT AVE STE L, TUSTIN, CA 92780-3746
(714) 544-1521
(888) 415-3257
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
G83575
CA
Other
Enumeration date
05/09/2017
Last updated
04/22/2025
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