Ellner Bariatric Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

G85289 Issued in CA

Legal business name

ELLNER BARIATRIC INC

Practice address

2878 Camino del Rio S Ste 303
San Diego, CA 92108-3847

Phone

(619) 286-7866

Fax

(619) 286-7867

NPI assigned

Mar 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Julie A Ellner, MDNPI 1104876762

Title

Owner

Phone

(619) 286-7866

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie A Ellner, M.D.

  • Surgery Physician
  • San Diego, CA
  • NPI 1104876762
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1043330277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2878 CAMINO DEL RIO S STE 303",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083847",
            "telephone_number": "619-286-7866",
            "fax_number": "619-286-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2878 CAMINO DEL RIO S STE 303",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083847",
            "telephone_number": "619-286-7866",
            "fax_number": "619-286-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLNER BARIATRIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "ELLNER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-286-7866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G85289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Jules Ellison, M.D.
• George W Ellison, M.D
• Kiyenna Ellison
• Theresa Kuni Ellithorpe, L.AC.
• Megan Ellmaker
• Julie A Ellner, M.D.
• Arleen Elloway, NP-C
• Lindy Elloway, PT
• Lacey Michelle Ellsworth, M.S., CCC-SLP
• Lauren Emma Ellsworth

• Specialist in San Diego, CA
• Providers in San Diego, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.