Provider Demographics
NPI:1679506612
Name:HARWAY, ELANA C (MD)
Entity type:Individual
Prefix:DR
First Name:ELANA
Middle Name:C
Last Name:HARWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2050 S BLOSSER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7310
Mailing Address - Country:US
Mailing Address - Phone:805-361-8028
Mailing Address - Fax:805-361-8097
Practice Address - Street 1:77 CASA ST
Practice Address - Street 2:201
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-5803
Practice Address - Country:US
Practice Address - Phone:805-269-1500
Practice Address - Fax:805-269-1585
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2016-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG68268207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG68268OtherBLUE CROSS OF CA
CA00G682680Medicaid
CA00G682680OtherBLUE SHIELD OF CA
CA00G682680Medicaid
CAP00406973Medicare PIN
CA00G682680OtherBLUE SHIELD OF CA