Provider Demographics
NPI:1588294706
Name:NASH, ELIAS J (MD)
Entity type:Individual
Prefix:
First Name:ELIAS
Middle Name:J
Last Name:NASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 EL CAJON BLVD, CITY HEIGHTS FAMILY HEALTH CENTER
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115
Mailing Address - Country:US
Mailing Address - Phone:619-515-2400
Mailing Address - Fax:
Practice Address - Street 1:5454 EL CAJON BLVD, CITY HEIGHTS FAMILY HEALTH CENTER
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115
Practice Address - Country:US
Practice Address - Phone:619-515-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2022-06-06
Deactivation Date:2022-05-04
Deactivation Code:
Reactivation Date:2022-06-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program