Provider Demographics
NPI:1932192747
Name:ELIAS, CELIA (MD)
Entity Type:Individual
Prefix:
First Name:CELIA
Middle Name:
Last Name:ELIAS
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 1:5902 E PIMA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4322
Mailing Address - Country:US
Mailing Address - Phone:520-452-0388
Mailing Address - Fax:877-281-8622
Practice Address - Street 1:5902 E PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4322
Practice Address - Country:US
Practice Address - Phone:520-886-5315
Practice Address - Fax:520-298-8204
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26173207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ293655Medicaid
AZ293655Medicaid
AZZ24057Medicare PIN
AZ72546Medicare ID - Type Unspecified
AZZ120585Medicare PIN