Provider Demographics
NPI:1407874688
Name:LAGANA, ELISA MARIA (DPM)
Entity Type:Individual
Prefix:DR
First Name:ELISA
Middle Name:MARIA
Last Name:LAGANA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223231
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93922-3231
Mailing Address - Country:US
Mailing Address - Phone:831-238-3030
Mailing Address - Fax:831-603-7181
Practice Address - Street 1:27565 VIA SERENO
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-9533
Practice Address - Country:US
Practice Address - Phone:831-238-3030
Practice Address - Fax:831-603-7181
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4367213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU91371Medicare UPIN
CA000E43671Medicare ID - Type Unspecified