Individual provider Active NPI

Eliza Gollub, N.P.

  • Adult Health Nurse Practitioner
  • Beverly Hills, CA
National Provider Identifier
1952743288
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95003022 Issued in CA
Practice address
9725 Wilshire Blvd
Beverly Hills, CA 90212
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Jul 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NPP37773 RI
Adult Health Nurse Practitioner 363LA2200X 084009-23 NH
Adult Health Nurse Practitioner 363LA2200X RN2269752 MA
Adult Health Nurse Practitioner 363LA2200X 95003022 CA Primary

Addresses

Primary practice location

9725 Wilshire Blvd
Beverly Hills, CA 90212

Mailing address

9725 Wilshire Blvd
Beverly Hills, CA 90212-2002
Phone (323) 305-7150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170810001529 CA Practitioner - Nurse Practitioner 8527299072 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2269752MAMDAdult Health Nurse Practitioner
084009-23NHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc. CurrentSince Jun 12, 2017 Accepting new patients
One Medical Group, Inc CurrentSince Jun 12, 2017 Accepting new patients

Locations

900 Veterans Blvd
Ste 150
Redwood City, CA 94063
Phone (650) 298-8774

2 Embarcadero Ctr
Lbby
San Francisco, CA 94111
Phone (415) 529-4566

559 Clay St
#200
San Francisco, CA 94111
Phone (415) 830-4744

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1952743288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9725 WILSHIRE BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122002",
            "telephone_number": "323-305-7150",
            "fax_number": "323-305-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 WILSHIRE BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90212",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLUB",
        "first_name": "ELIZA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "NPP37773",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NH",
            "license": "084009-23",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2269752",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95003022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.