Provider Demographics
NPI:1497591663
Name:MAGHAR, ELMERA (CPE,LE)
Entity type:Individual
Prefix:
First Name:ELMERA
Middle Name:
Last Name:MAGHAR
Suffix:
Gender:F
Credentials:CPE,LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 COLFAX AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2897
Mailing Address - Country:US
Mailing Address - Phone:949-916-9944
Mailing Address - Fax:
Practice Address - Street 1:4321 COLFAX AVE APT 10
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2897
Practice Address - Country:US
Practice Address - Phone:949-916-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-06
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL9925174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist