Individual
AUDREY ROBIN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
770 E CALAVERAS BLVD, MILPITAS, CA 95035-5491
(650) 945-2900
Mailing address
1800 HARRISON ST FL 7, OAKLAND, CA 94612-3429
(510) 625-6262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G47519
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G475190
—
CA
Enumeration date
10/31/2006
Last updated
07/08/2007
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