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General NPI Number Information
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NPI Number | 1023939261
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Entity Type | Organization
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Legal Business Name | ELITE CARE MOBILE MEDICAL GROUP
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 2950 E FLAMINGO RD STE J3
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City | LAS VEGAS
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State | NV
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Zip | 89121-5209
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Country | US
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Telephone | 510-520-3369
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Fax |
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Provider Business Mailing Address
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Address Line | 2950 E FLAMINGO RD STE J3
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City | LAS VEGAS
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State | NV
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Zip | 89121-5209
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Country | US
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Telephone | 510-520-3369
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANTONIO LUIS DE PERALTA
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Credential | NP
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Telephone | 510-520-3369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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