Individual
DR. WLADISLAW V ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13847 MALLORY CT, GRASS VALLEY, CA 95949
(510) 849-4703
(530) 477-6092
Mailing address
13847 MALLORY CT, GRASS VALLEY, CA 95949-7658
(510) 849-4703
(530) 477-6092
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
A24351
CA
Other
Enumeration date
07/05/2005
Last updated
11/16/2018
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