Provider Demographics
NPI:1659340156
Name:ELIHU, NADIA (MD)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:ELIHU
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 1:1010 W. LA VETA
Mailing Address - Street 2:SUITE 750
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4312
Mailing Address - Country:US
Mailing Address - Phone:714-361-6600
Mailing Address - Fax:714-919-8804
Practice Address - Street 1:1010 W LA VETA AVE
Practice Address - Street 2:STE 750
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4300
Practice Address - Country:US
Practice Address - Phone:714-361-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67627207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110226061OtherRAIL ROAD MEDICARE - PROVIDER PTAN
1912919804OtherNPI - TYPE 2
CACG5665OtherRAIL ROAD MEDICARE - GROUP PTAN
CAW1514OtherMEDICARE PTAN - TYPE 2
CAW1514OtherMEDICARE PTAN - TYPE 2
CAH43423Medicare UPIN
CAWA67627BMedicare PIN
1447410519OtherNPI - TYPE 2
CAWA67627AMedicare PIN