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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Elliotts Pharmacy | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| Registration number | GP154899 · PHA204250 · PHA323360 · PHA433010 | [sources] | |||
| Sector | Physician | [sources] | |||
| Address | 21 Castillo, Irvine, CA · 9049 Garfield Ave., Fountain Valley, CA · 9113 Garfield Ave., Fountain Valley, CA | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States of America · DHCS
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | Department of Health Care Services | - | |||
| Linked to | ||||
|---|---|---|---|---|
| Object | Role | Start date | End date | |
| KM Corp Debarred entity | - | - | - | |