Organization
CROSS SPEECH AND LANGUAGE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID S. ELAM M.A.CCC (OWNER/DIRECTOR)
(805) 733-4542
Entity
Organization
Contact information
Practice address
1133 N H ST, SUITE I, LOMPOC, CA 93436-3368
(805) 733-4542
(805) 733-4392
Mailing address
1133 N H ST, SUITE I, LOMPOC, CA 93436-3368
(805) 733-4542
(805) 733-4392
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP5420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSP000390
—
CA
01
—
ZZZ05144Z
BLUE SHIELD PROVNUM
CA
Enumeration date
10/09/2007
Last updated
02/15/2017
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