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NPI Code Detail

MEDICARE: ELITE MEDICAL GROUP LLC

MEDICARE: ELITE MEDICAL GROUP LLC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1841841541
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE MEDICAL GROUP LLC
Provider Business Mailing Address
First Line : 8687 W SAHARA AVE STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-5869
Country : US
Telephone Number : 702-509-9904
Fax Number : 702-509-9921
Provider Business Practice Location Address
First Line : 2170 E HARMON AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7840
Country : US
Telephone Number : 702-509-9904
Fax Number : 702-509-9921
Authorized Official
Title or Position : MD
Name : MANOJ NATH
Credential :
Telephone Number : 702-509-9904
Provider Enumeration Date : 09/24/2019
Last Update Date : 11/15/2022

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Directions to “ELITE MEDICAL GROUP LLC ” Practice Location

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