Provider Demographics
NPI:1215285010
Name:ELLIOT BLAU, DO, LTD
Entity type:Organization
Organization Name:ELLIOT BLAU, DO, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-947-7609
Mailing Address - Street 1:7002 E OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6325
Mailing Address - Country:US
Mailing Address - Phone:480-947-7609
Mailing Address - Fax:480-947-5341
Practice Address - Street 1:7002 E OSBORN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6325
Practice Address - Country:US
Practice Address - Phone:480-947-7609
Practice Address - Fax:480-947-5341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ846261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty