Provider Demographics
NPI:1083614986
Name:ZOBERMAN-SALTIEL, ELAINE (MD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:ZOBERMAN-SALTIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 S HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7933
Mailing Address - Country:US
Mailing Address - Phone:888-988-2800
Mailing Address - Fax:714-427-7969
Practice Address - Street 1:3401 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7933
Practice Address - Country:US
Practice Address - Phone:888-988-2800
Practice Address - Fax:714-427-7969
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87780207N00000X
NY147173207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07015OtherMVP
NY32E5610OtherEMPIRE
NY10002241OtherCDPHP
NY07015OtherMVP
NY10002241OtherCDPHP