| Doctor Name: | ELSIE PEARL URSUA DY |
| NPI Number: | 1881624575 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | LP00056071 |
| Business Practice Address: | 5239a Prospect Ct Fort Irwin, CA - 923102105 |
| Business Phone Number: | 7603864219 |
| Business Fax Number: | |
| Mailing Address: | 5239a Prospect Ct, FORT IRWIN |
| State: | CA |
| Postal Code: | 923102105 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 286500000X |
| License Number: | LP00056071 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Military Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care facility operated by the Department of Defense. |