MEDICARE: ELITE NEUROLOGY OF ORANGE COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	G81195	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1083019830	OTHER	CA	GROUP NPI
2	1841210846	OTHER	CA	NPI
3	G81195	OTHER	CA	MEDICAL BOARD OF CA

General Provider Information

NPI Number	:	1083019830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE NEUROLOGY OF ORANGE COUNTY

Provider Business Mailing Address
First Line	:	2617 E CHAPMAN AVE STE 101
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92869-3251
Country	:	US
Telephone Number	:	714-202-0218
Fax Number	:	714-422-0969

Provider Business Practice Location Address
First Line	:	2617 E CHAPMAN AVE STE 101
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92869-3251
Country	:	US
Telephone Number	:	714-202-0218
Fax Number	:

Authorized Official
Title or Position	:	BILLER
Name	:	MRS. CONSUELO AGUIRRE
Credential	:
Telephone Number	:	719-322-5654

Provider Enumeration Date	:	10/22/2014
Last Update Date	:	02/04/2026

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Directions to “ELITE NEUROLOGY OF ORANGE COUNTY ” Practice Location

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