Elboim, Charles Martin

Elboim, Charles Martin is an individual health care provider with primary practice located at 121 Sotoyome St , Santa Rosa CA 95405-4823. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Elboim, Charles Martin can be contacted via phone (707) 525-6180.

Contact Information

Primary practice address
121 Sotoyome St Santa Rosa CA 95405-4823
Phone: (707) 525-6180
Fax: (707) 521-3854
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X C41968 California
Allopathic & Osteopathic Physicians / Surgery 208600000X C41968 California

Profile Details

NPI number 1770672610
LBN Legal business name Elboim, Charles Martin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Jan 25th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770672610 NPPES
California MEDICAID 00C419680

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