Active NPI
Isaac Gabriel Eliaz, MD
- Public Health & General Preventive Medicine Physician
- Sebastopol, CA
National Provider Identifier
1225247729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- A73390
- Practice address
- 7064 Corline CT
Suite a
Sebastopol, CA 95472-4528 - Phone
- (707) 829-5900
- Fax
- (707) 829-5282
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | A73390 | CA | Primary |
Addresses
Primary practice location
7064 Corline CT
Suite a
Sebastopol, CA 95472-4528
Mailing address
7064 Corline CT
Suite a
Sebastopol, CA 95472-4528
Phone (707) 829-5900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 26, 2013 through Nov 26, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73390 | CA | MD | Pharmacist |
| A73390 | CA | MD | Public Health & General Preventive Medicine Physician |
Interoperability endpoints
- isaac.eliaz@45440675545092.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225247729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7064 CORLINE CT",
"address_2": "SUITE A",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954724528",
"telephone_number": "707-829-5900",
"fax_number": "707-829-5282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7064 CORLINE CT",
"address_2": "SUITE A",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954724528",
"telephone_number": "707-829-5900",
"fax_number": "707-829-5282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIAZ",
"first_name": "ISAAC",
"middle_name": "GABRIEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "CA",
"license": "A73390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sebastopol, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.