Provider Demographics
NPI:1184905044
Name:WHITLOCK, ELIZABETH LOUISA (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LOUISA
Last Name:WHITLOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PARNASSUS AVE
Mailing Address - Street 2:CAMPUS BOX 0648
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2203
Mailing Address - Country:US
Mailing Address - Phone:415-514-3781
Mailing Address - Fax:415-514-0185
Practice Address - Street 1:500 PARNASSUS AVE
Practice Address - Street 2:CAMPUS BOX 0648
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2203
Practice Address - Country:US
Practice Address - Phone:415-514-3781
Practice Address - Fax:415-514-0185
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA126068207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology