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General NPI Number Information
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NPI Number | 1841841541
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Entity Type | Organization
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Legal Business Name | ELITE MEDICAL GROUP LLC
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 2170 E HARMON AVE
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City | LAS VEGAS
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State | NV
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Zip | 89119-7840
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Country | US
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Telephone | 702-509-9904
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Fax | 702-509-9921
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Provider Business Mailing Address
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Address Line | 8687 W SAHARA AVE STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89117-5869
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Country | US
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Telephone | 702-509-9904
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Fax | 702-509-9921
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Authorized Official
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Title or Position | MD
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Name | MANOJ NATH
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Credential |
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Telephone | 702-509-9904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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