Individual
NANCY A ELLERBROEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25751 MCBEAN PKWY, STE. 110, VALENCIA, CA 91355-3701
(661) 259-2990
(661) 259-1031
Mailing address
PO BOX 513969, LOS ANGELES, CA 90051-3969
(310) 335-4065
(310) 335-4098
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G53683
CA
2085R0001X
Radiation Oncology Physician
Primary
G53683
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G536830
—
CA
05
—
19874545
—
CO
Enumeration date
11/27/2005
Last updated
05/29/2015
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