Provider Demographics
NPI:1730204306
Name:MAZER, ELLIOT EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:EUGENE
Last Name:MAZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5208 TAMSEN CT
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-6036
Mailing Address - Country:US
Mailing Address - Phone:916-485-8522
Mailing Address - Fax:916-485-0144
Practice Address - Street 1:7000 FRANKLIN BLVD
Practice Address - Street 2:SUITE 1020
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-1820
Practice Address - Country:US
Practice Address - Phone:916-424-8412
Practice Address - Fax:916-424-3249
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG25949207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA42849Medicare UPIN