Individual
CHARLES MARTIN ELBOIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
121 SOTOYOME ST, SANTA ROSA, CA 95405-4823
(707) 525-6180
(707) 521-3854
Mailing address
121 SOTOYOME ST, SANTA ROSA, CA 95405-4823
(707) 525-6180
(707) 521-3854
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C41968
CA
2086S0129X
Vascular Surgery Physician
C41968
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C419680
—
CA
Enumeration date
10/11/2006
Last updated
01/25/2021
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