Individual provider · Type 1 NPI

Desta Ellis, MD

Student in an Organized Health Care Education/Training Program · Visalia, CA

NPI number 1295140887 Active

Practice location

400 W Mineral King Ave
Visalia, CA 93291-6237

Call (559) 624-6999 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1295140887

Desta Ellis, MD's National Provider Identifier is 1295140887, issued on Jun 23, 2014. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Visalia, CA. The record was last updated on Jun 23, 2014.