Provider Demographics
NPI:1043391667
Name:NELSON, ELVERT FRANKLYN (MD)
Entity Type:Individual
Prefix:
First Name:ELVERT
Middle Name:FRANKLYN
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 COYLE AVE 290
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-6367
Mailing Address - Country:US
Mailing Address - Phone:916-536-9800
Mailing Address - Fax:916-536-0195
Practice Address - Street 1:6660 COYLE AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6335
Practice Address - Country:US
Practice Address - Phone:916-536-9800
Practice Address - Fax:916-536-0195
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG388410207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G388410Medicaid
G38841Medicare ID - Type Unspecified
CA00G388410Medicaid