Healthcare Provider Details

I. General information

NPI: 1487565610
Provider Name (Legal Business Name): ELICERE HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10845 GRIFFITH PEAK DR STE 200
LAS VEGAS NV
89135-1568
US

IV. Provider business mailing address

10845 GRIFFITH PEAK DR STE 200
LAS VEGAS NV
89135-1568
US

V. Phone/Fax

Practice location:
  • Phone: 702-577-0143
  • Fax:
Mailing address:
  • Phone: 702-577-0143
  • Fax:

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: HO SUNG PAK
Title or Position: PRESIDENT
Credential: DO
Phone: 702-577-0143