Individual
THOMAS K ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO
Contact information
Practice address
2120 FOREST AVE, SUITE 3, SAN JOSE, CA 95128-1478
(408) 217-9387
(408) 866-4045
Mailing address
1700 N CHRISMAN ROAD, TRACY, CA 95304-9314
(800) 726-9180
(800) 866-5950
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CO002151
CA
246Z00000X
Other Specialist/Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XA0021510
—
CA
Enumeration date
02/01/2011
Last updated
08/10/2012
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