Provider Demographics
NPI:1548298623
Name:CURTIS, ELAINE LOIS (MD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:LOIS
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:752 MEDICAL CENTER CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6658
Mailing Address - Country:US
Mailing Address - Phone:619-421-4311
Mailing Address - Fax:616-421-3838
Practice Address - Street 1:752 MEDICAL CENTER CT
Practice Address - Street 2:SUITE 200
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6658
Practice Address - Country:US
Practice Address - Phone:619-421-4311
Practice Address - Fax:616-421-3838
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA41362207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB79468Medicare UPIN
CAA41362Medicare ID - Type UnspecifiedMEDICARE