Provider Demographics
NPI:1194821140
Name:SCHAFFZIN, ELLIOTT ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:ARTHUR
Last Name:SCHAFFZIN
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 1:1250 LA VENTA DR
Mailing Address - Street 2:STE 100
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-3702
Mailing Address - Country:US
Mailing Address - Phone:805-381-1953
Mailing Address - Fax:805-381-1079
Practice Address - Street 1:1250 LA VENTA DR
Practice Address - Street 2:STE 100
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-3702
Practice Address - Country:US
Practice Address - Phone:805-381-1953
Practice Address - Fax:805-381-1079
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33746207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG33746OtherMEDICARE PTAN
CAG33746OtherMEDICARE PTAN