1891580841 NPI number — DR. ELIAS VALENTIN MURILLO CISNEROS MD

Table of content: DR. ELIAS VALENTIN MURILLO CISNEROS MD (NPI 1891580841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891580841 NPI number — DR. ELIAS VALENTIN MURILLO CISNEROS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURILLO CISNEROS
Provider First Name:
ELIAS
Provider Middle Name:
VALENTIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891580841
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
970 WALNUT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLTVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92250-1337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-554-7927
Provider Business Mailing Address Fax Number:
760-554-7927

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1701 VETERANS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35630-4928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-629-1950
Provider Business Practice Location Address Fax Number:
256-629-2765
Provider Enumeration Date:
04/10/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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