Healthcare Provider Details

I. General information

NPI: 1255910519
Provider Name (Legal Business Name): ELEVATED HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18800 DELAWARE ST STE 800
HUNTINGTON BEACH CA
92648-6019
US

IV. Provider business mailing address

18800 DELAWARE ST STE 800
HUNTINGTON BEACH CA
92648-6019
US

V. Phone/Fax

Practice location:
  • Phone: 714-916-5210
  • Fax: 714-916-5494
Mailing address:
  • Phone: 714-916-5210
  • Fax: 714-916-5494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW ABINANTE
Title or Position: OWNER
Credential: MD
Phone: 714-916-5210