Provider Demographics
NPI:1508870577
Name:FELMAN, ELLIOT D (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:D
Last Name:FELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2336 SANTA MONICA BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-453-0033
Mailing Address - Fax:310-453-2114
Practice Address - Street 1:1821 WILSHIRE BLVD STE 301A
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5679
Practice Address - Country:US
Practice Address - Phone:310-260-2525
Practice Address - Fax:310-260-7575
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG18619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A40377Medicare UPIN
CAW8614Medicare ID - Type Unspecified