Individual
DR. DALE SAMUEL ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18582 BEACH BLVD, SUITE 23A, HUNTINGTON BEACH, CA 92648-2000
(714) 964-4448
Mailing address
3400 AVENUE OF THE ARTS, J422, COSTA MESA, CA 92626-2338
(714) 444-9958
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A40971
CA
Other
Enumeration date
04/13/2006
Last updated
07/08/2007
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