Elevate Md Services | |
16180 Dante Pl Fontana CA 92336-5952 | |
(909) 434-5910 | |
Not Available |
Full Name | Elevate Md Services |
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Speciality | Internal Medicine |
Location | 16180 Dante Pl, Fontana, California |
Authorized Official Name and Position | Cheyenne Chitry (CEO) |
Authorized Official Contact | 9094345910 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Elevate Md Services 16180 Dante Pl Fontana CA 92336-5952 Ph: (909) 434-5910 | Elevate Md Services 16180 Dante Pl Fontana CA 92336-5952 Ph: (909) 434-5910 |
NPI Number | 1891569828 |
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Provider Enumeration Date | 11/09/2023 |
Last Update Date | 11/09/2023 |
Medicare PECOS PAC ID | 9436598562 |
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Medicare Enrollment ID | O20240422002045 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891569828 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Sara H Ghazi |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1861816886 PECOS PAC ID: 8527376227 Enrollment ID: I20150929003505 |
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