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Dr. Elliott J Caine
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NPI Number Detailed Information
Provider Information:
Name: | Dr. Elliott J Caine |
Gender: | M |
Provider License Number If Given: | OPT6005T |
NPI Information:
NPI: | 1558355040 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 9/12/2005 |
Last Update Date: | 5/12/2009 |
Provider Business Mailing Address:
Address: | 5016 YORK BLVD Los Angeles, CA 90042 |
Phone Number: | 6264039810 |
Fax Number: | 6264034597 |
Provider Business Practice Location Address:
Address: | 5016 YORK BLVD Los Angeles, CA 90042 |
Phone Number: | 6264039810 |
Fax Number: | 6264034597 |
Provider Taxonomy:
Primary: | 152W00000X |
Secondary (if any): | |
State: | CA |