Provider Demographics
NPI:1427812627
Name:BESIROVIC, ELMA
Entity type:Individual
Prefix:
First Name:ELMA
Middle Name:
Last Name:BESIROVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2539 BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3021
Mailing Address - Country:US
Mailing Address - Phone:925-322-7905
Mailing Address - Fax:
Practice Address - Street 1:1420 WILLOW PASS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5823
Practice Address - Country:US
Practice Address - Phone:925-646-5480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator