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General NPI Number Information
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NPI Number | 1538046297
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Entity Type | Organization
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Legal Business Name | ELITE REGENERATIVE HEALTH INC
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Dates
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Enumeration Date | 08/16/2025
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Last Update Date | 08/16/2025
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Provider Practice Location Address
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Address Line | 3605 LONG BEACH BLVD STE 210F
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City | LONG BEACH
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State | CA
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Zip | 90807-4013
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Country | US
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Telephone | 949-981-2670
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 LONG BEACH BLVD STE 210F
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City | LONG BEACH
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State | CA
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Zip | 90807-4013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | LUKE NARCISO
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Credential | FNP-BC
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Telephone | 949-981-2670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family 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 | 363L00000X
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Taxonomy Name | 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 | 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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