MEDICARE: ELITE HOSPITALIST MEDICAL GROUP, INC.

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639598758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE HOSPITALIST MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	4535 DRESSLER RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2545
Country	:	US
Telephone Number	:	844-474-4019
Fax Number	:

Provider Business Practice Location Address
First Line	:	29101 HOSPITAL RD
Second Line	:
City	:	LAKE ARROWHEAD
State	:	CA
Zip	:	92352-9706
Country	:	US
Telephone Number	:	844-474-4019
Fax Number	:	909-336-5031

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVEN P. MARON
Credential	:	M.D.
Telephone Number	:	626-447-0296

Provider Enumeration Date	:	04/16/2014
Last Update Date	:	11/30/2023

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