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ELENA YUREVNA AGAFONOVA M.D.
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1558757666
Individual Registrant: ELENA YUREVNA AGAFONOVA M.D.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1400 E CHURCH ST SANTA MARIA, CA 93454-5906 US
Tel: 805-739-3000 Fax: --
Tel: 805-739-3000 Fax: --
Contact information for business:
791 PRICE ST # 501 PISMO BEACH, CA 93449-2529 US
Tel: 435-513-2213 Fax: --
Tel: 435-513-2213 Fax: --
Registration Information:
NPI: 1558757666
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | CA | A150661 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
