Provider Demographics
NPI:1477780674
Name:ELG, CRAIG (PHARMD BCOP)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:ELG
Suffix:
Gender:M
Credentials:PHARMD BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 N INDIAN CANYON DR
Mailing Address - Street 2:SUITE E. 218
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUITE E. 218
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-416-4853
Practice Address - Fax:760-416-4726
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA548341835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology