Provider Demographics
NPI:1629502018
Name:ELKIN, RACHEL LEILANI (RCP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LEILANI
Last Name:ELKIN
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9838 MISSION VEGA RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4232
Mailing Address - Country:US
Mailing Address - Phone:619-820-6962
Mailing Address - Fax:
Practice Address - Street 1:9838 MISSION VEGA RD UNIT 2
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4232
Practice Address - Country:US
Practice Address - Phone:619-820-6962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315762279P1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function Technologist