Provider Demographics
NPI:1730393398
Name:DU, ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 E CALIFORNIA BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3205
Mailing Address - Country:US
Mailing Address - Phone:626-568-8838
Mailing Address - Fax:626-583-8838
Practice Address - Street 1:12828 HARBOR BLVD STE 305
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5835
Practice Address - Country:US
Practice Address - Phone:800-898-2020
Practice Address - Fax:844-897-3788
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2023-01-09
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Provider Licenses
StateLicense IDTaxonomies
MI4301088530207W00000X
CAC142813207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1730393398Medicaid
CACA210181Medicare PIN
CA1730393398Medicaid