Elijah Thomas Wolf Lustig, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

3293 Issued in CA

Practice address

1411 E 31St St
Oakland, CA 94602-1018

Phone

(510) 384-9737

NPI assigned

Jul 29, 2019

Last updated

Oct 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1518511443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-384-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-384-9737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Virginia St",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945906020",
            "country_code": "US",
            "telephone_number": "707-638-5970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "ELIJAH",
        "middle_name": "THOMAS WOLF",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-29",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "3293",
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louisa Lurkis, PH.D.
• Brenda Lush
• Marsha Anne Luster, MSW
• Sasha Lustgarten, M.A., MFT
• Anisya Lustig-Ellison
• Lilian Iulia Lustman, M.D.
• Evan Alexander Lutz, AMFT
• Katherine Lutz
• Robert Luu, MD
• Yen Khai Luu, B.A.

• Internal Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.