Provider Demographics
NPI:1952377913
Name:DREISBACH, ELVA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELVA
Middle Name:LYNN
Last Name:DREISBACH
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 1:2232 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501
Mailing Address - Country:US
Mailing Address - Phone:310-257-2598
Mailing Address - Fax:310-326-3605
Practice Address - Street 1:2232 SEPULVEDA BLVD
Practice Address - Street 2:HEALTHCARE PARTNERS
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-5301
Practice Address - Country:US
Practice Address - Phone:310-257-2598
Practice Address - Fax:310-326-3605
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG074704207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG-73972Medicare UPIN