Individual
EDWARD ALBERT ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3017 SANTA MONICA BLVD, STE 307, SANTA MONICA, CA 90404-2534
(310) 829-5540
(310) 861-5750
Mailing address
3017 SANTA MONICA BLVD, 307, SANTA MONICA, CA 90404-2534
(310) 829-5540
(310) 861-5750
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G46299
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G462991
—
CA
05
—
00G462992
—
CA
Enumeration date
07/07/2006
Last updated
04/21/2009
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