| Thomas W. Ela, M.D., Inc. | |
|
2282 N State College Blvd Fullerton CA 92831-1362 | |
| (714) 780-9770 | |
| (714) 780-9773 |
| Full Name | Thomas W. Ela, M.D., Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2282 N State College Blvd, Fullerton, California |
| Authorized Official Name and Position | Thomas W Ela (PRESIDENT / PHYSICIAN) |
| Authorized Official Contact | 7147809770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas W. Ela, M.D., Inc. Po Box 2666 Seal Beach CA 90740-1666 Ph: (714) 780-9770 | Thomas W. Ela, M.D., Inc. 2282 N State College Blvd Fullerton CA 92831-1362 Ph: (714) 780-9770 |
| NPI Number | 1588863716 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 02/26/2019 |
| Medicare PECOS PAC ID | 1759325335 |
|---|---|
| Medicare Enrollment ID | O20050614001368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588863716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | G65793 (California) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (California) | Primary |
| Provider Name | Thomas W Ela |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831184795 PECOS PAC ID: 3678519519 Enrollment ID: I20100802000718 |
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