Individual
DR. PETER ELSISSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 W LUGONIA AVE STE 120, REDLANDS, CA 92374-9704
(909) 557-1600
(909) 557-1731
Mailing address
1801 ORANGE TREE LN STE 200, REDLANDS, CA 92374-4587
(909) 557-1600
(909) 557-1732
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
A100039
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/07/2007
Last updated
02/24/2020
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