Elliot Ryan Carlisle MD Inc

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

A74780 Issued in CA

Legal business name

ELLIOT RYAN CARLISLE MD INC

Practice address

17525 Ventura Blvd Ste 203
Encino, CA 91316-5109

Phone

(310) 986-0200

Fax

(818) 986-4390

NPI assigned

May 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Elliot Ryan Carlisle, MD

Title

Owner and Surgeon

Phone

(818) 986-0200

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1427225440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17525 VENTURA BLVD STE 203",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165109",
            "telephone_number": "310-986-0200",
            "fax_number": "818-986-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17525 VENTURA BLVD STE 203",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165109",
            "telephone_number": "310-986-0200",
            "fax_number": "818-986-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT RYAN CARLISLE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER AND SURGEON",
        "authorized_official_telephone_number": "818-986-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A74780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A74780",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1669453676",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elkb Group LLC (Encino Detox Center)
• Amanda Pino Elkin
• Brad Steven Elkins, M.D.
• Randi Elkins, MS CCC-SLP
• Susanne Elkrief, MA, OTR/L
• Dennis Elliott Jr., DACM, L.AC.
• Gina Elliott, M.A. CCC-SLP
• Dock Phillip Ellis III
• Hsiao Chien Ellis, L.AC.
• Jennifer Ellis, NP

• Orthopaedic Surgery of the Spine Physician in Encino, CA
• Providers in Encino, CA by specialty
• Orthopaedic Surgery of the Spine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.