Elliot R Klaw, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G38577 Issued in CA

Practice address

689 Tank Farm Road
Suite 220
San Luis Obispo, CA 93401-7079

Phone

(805) 541-1177

Fax

(805) 541-4973

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Central Coast Health Centers

  • Community Health Clinic/Center
  • Santa Maria, CA
  • NPI 1063496651
  NPD (past)
• Pacific Central Coast Health Centers

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)
• Jay M. Wolkov DO PC

  • Multi-Specialty Clinic/Center
  • Gunnison, CO
  • NPI 1649368663
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1568524130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WEST BUNNY AVENUE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934582805",
            "telephone_number": "805-739-3474",
            "fax_number": "805-739-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 TANK FARM ROAD",
            "address_2": "SUITE 220",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017079",
            "telephone_number": "805-541-1177",
            "fax_number": "805-541-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAW",
        "first_name": "ELLIOT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G38577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CB218534",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty Kisling
• Phillip Kissel, M.D.
• Ian Kizanis
• Brian Klassen
• Anna Klauer, PSYD
• Kailee Klebba
• Carissa Klein
• Lisa Anne Klein
• Brooke Klever
• John Lewis Klevins, MSW

• Internal Medicine Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, 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 Sep 14, 2015; 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.