Individual
CHRISTINE ELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
785 MAIN ST, HALF MOON BAY, CA 94019-1992
(650) 712-8400
Mailing address
785 MAIN ST, SUITE A, HALF MOON BAY, CA 94019
(650) 712-8400
(650) 712-8600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT18744
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT18744
LICENSE #
CA
Enumeration date
03/08/2006
Last updated
10/07/2008
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