Provider Demographics
NPI:1609280478
Name:AHDOOT, ELI (DO)
Entity type:Individual
Prefix:
First Name:ELI
Middle Name:
Last Name:AHDOOT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:191 S BUENA VISTA ST STE 370
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4562
Mailing Address - Country:US
Mailing Address - Phone:310-526-7144
Mailing Address - Fax:310-526-7157
Practice Address - Street 1:191 S BUENA VISTA ST STE 370
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4562
Practice Address - Country:US
Practice Address - Phone:310-526-7144
Practice Address - Fax:310-526-7157
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A14257207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery