Individual
DR. ELLIOT RYAN CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16311 VENTURA BLVD, SUITE 800, ENCINO, CA 91436-2124
(818) 788-7343
(818) 788-9453
Mailing address
17525 VENTURA BLVD, SUITE 203, ENCINO, CA 91316-3843
(818) 986-0200
(818) 986-4390
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A74780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A233730
—
CA
Enumeration date
11/07/2005
Last updated
12/29/2021
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