Provider Demographics
NPI:1871755629
Name:ELIAS, LYDIA TALAAT (DO)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:TALAAT
Last Name:ELIAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LYDIA
Other - Middle Name:TALAAT
Other - Last Name:KARAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3661 TORRANCE BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4812
Mailing Address - Country:US
Mailing Address - Phone:310-953-0020
Mailing Address - Fax:310-953-0019
Practice Address - Street 1:3661 TORRANCE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4812
Practice Address - Country:US
Practice Address - Phone:310-953-0020
Practice Address - Fax:310-953-0019
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A99432080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine