JOHN ELLOWAY MD A PROFESSIONAL CORP NPI 1174794770

NPI Information

  • NPI: 1174794770
  • Provider Name: JOHN ELLOWAY MD A PROFESSIONAL CORP
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: N/A
  • Address: 1324 GRANT AVE
    NOVATO, CA
    ZIP 94945
  • Phone: (415) 892-3300

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NPI Details

JOHN ELLOWAY MD A PROFESSIONAL CORP is a primary care clinic center in Novato, CA. JOHN ELLOWAY MD A PROFESSIONAL CORP NPI is 1174794770. The provider is registered as an organization entity type.
The provider Is Doing Business As N/a.

The provider's business location address is:

1324 GRANT AVE
NOVATO, CA
ZIP 94945-152
Phone: (415) 892-3300
Fax: (415) 897-0079

The provider's authorized official is John Elloway .
The authorized official title is Director and has the following contact phone number (415) 892-3300.

The enumeration date for this NPI number is 3/21/2008 and was last updated on 11/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareZZZ24941ZCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A22649MEDICARE UPINCALIFORNIA
2ZZZ24941ZMEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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