Provider Demographics
NPI:1346357431
Name:CANETE, ELIZABETH D (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:D
Last Name:CANETE
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7777 MILLIKEN AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6781
Mailing Address - Country:US
Mailing Address - Phone:909-941-0247
Mailing Address - Fax:909-948-7950
Practice Address - Street 1:7777 MILLIKEN AVE
Practice Address - Street 2:240
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6780
Practice Address - Country:US
Practice Address - Phone:909-941-0247
Practice Address - Fax:909-948-7950
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA98592207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADM179AMedicare PIN