Basic Information
| Provider Information | |||||||||
| NPI: | 1699050864 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ELENA PATTERSON MD A MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27200 CALAROGA AVE | ||||||||
| Address2: | |||||||||
| City: | HAYWARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945454339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102644000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 27200 CALAROGA AVE | ||||||||
| Address2: | |||||||||
| City: | HAYWARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945454339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102644000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2011 | ||||||||
| LastUpdateDate: | 10/19/2011 | ||||||||
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| AuthorizedOfficialLastName: | PATTERSON | ||||||||
| AuthorizedOfficialFirstName: | ELENA | ||||||||
| AuthorizedOfficialMiddleName: | O | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5102644000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A64360 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.