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1063922771
ANTHONY ELLIS
SAN JOSE, CA
NPI
1063922771
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95007645)
Enumeration Date
2017-10-07
Last Update Date
2017-10-07
Business Address
ANTHONY ELLIS NP
2105 FOREST AVE
SAN JOSE, CA 95128-1425
Phone number: 408-947-2500
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Mailing Address
ANTHONY ELLIS NP
44280 REVERE PL
FREMONT, CA 94539-5902
Phone number: 510-387-7011
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