Edward Albert Elliott, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G46299 Issued in CA

Practice address

3017 Santa Monica Blvd
Ste 307
Santa Monica, CA 90404-2534

Phone

(310) 829-5540

Fax

(310) 861-5750

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Golden State Behavioral

  • Psychiatry Physician
  • Glendale, CA
  • NPI 1487849006
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1780616979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 SANTA MONICA BLVD",
            "address_2": "307",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042534",
            "telephone_number": "310-829-5540",
            "fax_number": "310-861-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 SANTA MONICA BLVD",
            "address_2": "STE 307",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042534",
            "telephone_number": "310-829-5540",
            "fax_number": "310-861-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "EDWARD",
        "middle_name": "ALBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G46299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G462992",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G462991",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Elisabeth, PSY.D
• Fuad Fredric Elkhoury, M.D.
• Ellie JC Goldstein MD Inc
• Elliot D Felman MD (Elliot D Felman MD APC)
• Alex Elliott
• Thomas Robert Elliott
• Jasmine C. Ellison, LCSW
• Kaden Ellison
• John Winton Elman, O.D.
• Ryan Elmendorf

• Psychiatry Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.