Provider Demographics
NPI:1578917720
Name:MADRID-CARRANZA, ELINORA S (MD)
Entity Type:Individual
Prefix:
First Name:ELINORA
Middle Name:S
Last Name:MADRID-CARRANZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 HIDDEN VALLEY RD STE 150
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4217
Mailing Address - Country:US
Mailing Address - Phone:760-544-8233
Mailing Address - Fax:760-542-6030
Practice Address - Street 1:6010 HIDDEN VALLEY RD STE 150
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-4217
Practice Address - Country:US
Practice Address - Phone:760-544-8233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA150499207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine