Provider Demographics
NPI:1982777835
Name:ELBAUM, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:ELBAUM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2323 16TH ST
Mailing Address - Street 2:SUITE #204
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3420
Mailing Address - Country:US
Mailing Address - Phone:661-322-5333
Mailing Address - Fax:661-322-4775
Practice Address - Street 1:2323 16TH ST
Practice Address - Street 2:SUITE #204
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3420
Practice Address - Country:US
Practice Address - Phone:661-322-5333
Practice Address - Fax:661-322-4775
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2022-03-24
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Provider Licenses
StateLicense IDTaxonomies
CAG46033207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A50270Medicare UPIN