Individual
EDUARDO ELAZEGUI AMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3600 BROADWAY, OAKLAND, CA 94611-5730
(510) 752-8886
Mailing address
3630 MARATHON ST APT 133, LOS ANGELES, CA 90026-2867
(415) 786-2528
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
24756
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24756
—
CA
Enumeration date
01/04/2019
Last updated
01/07/2019
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