| Doctor Name: | HUSAM ELIAS |
| NPI Number: | 1053432054 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A113977 |
| Business Practice Address: | 4910 Van Nuys Blvd Suite 102 Sherman Oaks, CA - 91403 |
| Business Phone Number: | 8187896622 |
| Business Fax Number: | |
| Mailing Address: | 4910 Van Nuys Blvd, Suite 102 SHERMAN OAKS |
| State: | CA |
| Postal Code: | 914031715 |
| Phone Number: | 8187896622 |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 04/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | A113977 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |