Provider Demographics
NPI:1467454835
Name:TARAKJI, ELIAS ALBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:ALBERT
Last Name:TARAKJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:488 E SANTA CLARA ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-7232
Mailing Address - Country:US
Mailing Address - Phone:626-359-3330
Mailing Address - Fax:626-359-3339
Practice Address - Street 1:488 E SANTA CLARA ST STE 203
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7232
Practice Address - Country:US
Practice Address - Phone:626-359-3330
Practice Address - Fax:844-406-5406
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61002207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A610020Medicaid
CAA61002AMedicare PIN
CAG38246Medicare UPIN