Provider Demographics
NPI:1497974893
Name:ELZINGA, SHIRLEY WINTFRED (DC, LAC, CRNA)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:WINTFRED
Last Name:ELZINGA
Suffix:
Gender:F
Credentials:DC, LAC, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:415 NORTH CAMDEN DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210
Mailing Address - Country:US
Mailing Address - Phone:310-247-8045
Mailing Address - Fax:310-247-8047
Practice Address - Street 1:415 N CAMDEN DR
Practice Address - Street 2:SUITE 204
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4410
Practice Address - Country:US
Practice Address - Phone:310-247-8045
Practice Address - Fax:310-247-8047
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC19460111N00000X
CA220652163W00000X
CAAC3589171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered171100000XOther Service ProvidersAcupuncturist