Provider Demographics
NPI:1447073010
Name:ELISEO, ANNA TERESA MACALALAD (RN)
Entity type:Individual
Prefix:
First Name:ANNA TERESA
Middle Name:MACALALAD
Last Name:ELISEO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3527 DEERFORD ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-3535
Mailing Address - Country:US
Mailing Address - Phone:310-951-1336
Mailing Address - Fax:
Practice Address - Street 1:3527 DEERFORD ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-3535
Practice Address - Country:US
Practice Address - Phone:310-951-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider