Elba Healthcare, LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

3376 Issued in AZ

Legal business name

ELBA HEALTHCARE, LLC

Practice address

2450 S 4TH Ave
Suite 201
Yuma, AZ 85364-8573

Phone

(928) 257-4897

Fax

(866) 534-1701

NPI assigned

Jan 16, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Carl A Bonacci, PH.D.NPI 1659488583

Title

Owner

Phone

(928) 257-4897

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Carl Albert Bonacci, PH.D.

  • Psychologist
  • Phoenix, AZ
  • NPI 1659488583

  Clinical Neuropsychologist

  NPD (past) Authorized official

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1487830758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1349 E COLTER ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850143048",
            "telephone_number": "928-257-4897",
            "fax_number": "866-534-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S 4TH AVE",
            "address_2": "SUITE 201",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648573",
            "telephone_number": "928-257-4897",
            "fax_number": "866-534-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELBA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "BONACCI",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-257-4897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "3376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "872003",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Eggleston, PT, DPT
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• Fadi Eissa Darwich, M.D.
• Mohemed Moslih El Amin, M.D
• Elamin Medical PC
• Mahmoud Elbehery
• Jay Eldridge, P.T.
• Eleganz Medical Spa PLLC
• Joseph Eleid, MD
• Rocio A Eleid, M.D.

• All providers in Yuma, AZ
• Clinical Neuropsychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.