Provider Demographics
NPI:1124886908
Name:ELSA ANZALDO
Entity type:Organization
Organization Name:ELSA ANZALDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:ANZALDO FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-272-9021
Mailing Address - Street 1:591 TELEGRAPH CANYON RD STE 318
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-6436
Mailing Address - Country:US
Mailing Address - Phone:619-272-9021
Mailing Address - Fax:619-329-9663
Practice Address - Street 1:BLV AGUA CALIENTE 9150 L18
Practice Address - Street 2:
Practice Address - City:TIJUANA
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:22015
Practice Address - Country:MX
Practice Address - Phone:619-272-9021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty