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General NPI Number Information
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NPI Number | 1710533864
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Entity Type | Organization
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Legal Business Name | ELITE TRANSFORMATIONS, A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 1795 EL CAMINO REAL STE 200
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City | PALO ALTO
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State | CA
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Zip | 94306-1165
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Country | US
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Telephone | 888-844-5665
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Fax |
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Provider Business Mailing Address
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Address Line | 325 SHARON PARK DR # 648
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City | MENLO PARK
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State | CA
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Zip | 94025-6805
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Country | US
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Telephone | 702-362-5960
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ORNA FISHER
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Credential | MD
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Telephone | 702-362-5960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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