Provider Demographics
NPI:1619113479
Name:BRESLAR, ELLIOTT I (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:I
Last Name:BRESLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:E
Other - Middle Name:I
Other - Last Name:BRESLAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:651 COWLES RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-1801
Mailing Address - Country:US
Mailing Address - Phone:805-969-0456
Mailing Address - Fax:
Practice Address - Street 1:651 COWLES RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-1801
Practice Address - Country:US
Practice Address - Phone:805-969-0456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE9482207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology