Healthcare Provider Details

I. General information

NPI: 1679477137
Provider Name (Legal Business Name): ELEVATE CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 ARDEN AVE # 233
GLENDALE CA
91203-1102
US

IV. Provider business mailing address

340 ARDEN AVE # 233
GLENDALE CA
91203-1102
US

V. Phone/Fax

Practice location:
  • Phone: 747-567-6941
  • Fax:
Mailing address:
  • Phone: 747-567-6941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARIA ABAD
Title or Position: CEO
Credential:
Phone: 747-567-6941