Eli William Hallak, ATC
Individual provider Active NPI Athletic Trainer · La Canada, CA
NPI 1740244656 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1740244656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 200 Foothill Blvd
La Canada, CA 91011-3700 - Phone
- (818) 790-0325
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049702492 | CA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | CA | Yes |
Addresses
Primary practice location
200 Foothill Blvd
La Canada, CA 91011-3700
Mailing address
200 Foothill Blvd
La Canada, CA 91011-3700
Phone (818) 790-0325
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2255A2300X | Other | CA | ATHLETIC TRAINER |
Other providers in La Canada, CA
- Vanessa J Greco
- Nune Grigorian
- Kristina Grubbs
- Natascha Kontny Gundersen
- Satish Steve Gupta
- Farhad Hamidi
- Christine Hanna
- Clifford Thomas Hartman Jr.
- Hillary Lynne Haynes
- Healthylife MG Corp
All providers in La Canada, CA · Athletic Trainer in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.