Individual
MR. ELI WILLIAM HALLAK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
200 FOOTHILL BLVD, LA CANADA, CA 91011-3700
(818) 790-0325
Mailing address
200 FOOTHILL BLVD, LA CANADA, CA 91011-3700
(818) 790-0325
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
ATHLETIC TRAINER
CA
Enumeration date
04/17/2006
Last updated
07/08/2007
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