Provider Demographics
NPI:1942479746
Name:ELLIOTT, ROBERT MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3001 E TAHQUITZ CANYON WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6900
Mailing Address - Country:US
Mailing Address - Phone:760-832-5027
Mailing Address - Fax:760-620-5085
Practice Address - Street 1:3001 E TAHQUITZ CANYON WAY STE 104
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6900
Practice Address - Country:US
Practice Address - Phone:949-263-0800
Practice Address - Fax:657-304-0084
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG29258207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology