Provider Demographics
NPI:1508960840
Name:GARBER, ELAYNE K (MD)
Entity Type:Individual
Prefix:
First Name:ELAYNE
Middle Name:K
Last Name:GARBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8631 W 3RD ST
Mailing Address - Street 2:STE 700E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-854-3539
Mailing Address - Fax:310-652-3914
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:STE 700E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-854-3539
Practice Address - Fax:310-652-3914
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG32336207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G32336Medicare ID - Type Unspecified
A89522Medicare UPIN