Search › California › 2255A2300X
Keith Ellison, MA, ATC, CES
NPI 1568823318 · on the registry since 2016 · sole proprietor
Practice
- Address
- One Lmu Drive
Gersten Pavilion - Athletic Training Room
Los Angeles, CA 90045 - Phone
- (424) 789-4071
- Fax
- (310) 338-4401
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-03-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California