| Elite Hospitalist Medical Group, Inc. | |
|
29101 Hospital Rd Lake Arrowhead CA 92352-9706 | |
| (844) 474-4019 | |
| (909) 336-5031 |
| Full Name | Elite Hospitalist Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 29101 Hospital Rd, Lake Arrowhead, California |
| Authorized Official Name and Position | Steven P. Maron (PRESIDENT) |
| Authorized Official Contact | 6264470296 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Hospitalist Medical Group, Inc. 4535 Dressler Rd Nw Canton OH 44718-2545 Ph: (844) 474-4019 | Elite Hospitalist Medical Group, Inc. 29101 Hospital Rd Lake Arrowhead CA 92352-9706 Ph: (844) 474-4019 |
| NPI Number | 1639598758 |
|---|---|
| Provider Enumeration Date | 04/16/2014 |
| Last Update Date | 11/30/2023 |
| Medicare PECOS PAC ID | 9638394455 |
|---|---|
| Medicare Enrollment ID | O20141020002313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639598758 | NPI | - | NPPES |
| 1639598758 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ludwig Julian Cibelli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437198025 PECOS PAC ID: 7810800729 Enrollment ID: I20031106000836 |
| Provider Name | Kenneth Michael Dale |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932158771 PECOS PAC ID: 6901793637 Enrollment ID: I20040227001018 |
| Provider Name | Juk L Ting |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699713974 PECOS PAC ID: 3779486204 Enrollment ID: I20040301001214 |
| Provider Name | Steven Maron |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821026063 PECOS PAC ID: 7810806734 Enrollment ID: I20040317000955 |
| Provider Name | Robert A Shapiro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952332777 PECOS PAC ID: 1658347406 Enrollment ID: I20040902001508 |
| Provider Name | Michael John Martelli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306886304 PECOS PAC ID: 2365410040 Enrollment ID: I20040921000525 |
| Provider Name | Hassan Sheikho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982620829 PECOS PAC ID: 1850349002 Enrollment ID: I20050105000224 |
| Provider Name | Bijan Motamedi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801834171 PECOS PAC ID: 4284625104 Enrollment ID: I20060105000600 |
| Provider Name | David H Tang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386624179 PECOS PAC ID: 5395728653 Enrollment ID: I20080718000660 |
| Provider Name | Michael Phillips |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013927771 PECOS PAC ID: 8426093741 Enrollment ID: I20081229000260 |
| Provider Name | Lawrence R Burchett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619159639 PECOS PAC ID: 3072665322 Enrollment ID: I20090716000521 |
| Provider Name | Cheryl J Reeder |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417155318 PECOS PAC ID: 5890831283 Enrollment ID: I20100918000206 |
| Provider Name | Babek Adili-khams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588676811 PECOS PAC ID: 4688602642 Enrollment ID: I20110412000639 |
| Provider Name | Seth A Brener |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265606354 PECOS PAC ID: 5890964753 Enrollment ID: I20110810000072 |
| Provider Name | Amanda J Holden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538327713 PECOS PAC ID: 0941463574 Enrollment ID: I20120518000230 |
| Provider Name | Eric T Teacher |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033352984 PECOS PAC ID: 7113183575 Enrollment ID: I20120730000550 |
| Provider Name | Joy Marian Hardison |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851520688 PECOS PAC ID: 3577711456 Enrollment ID: I20120918000803 |
| Provider Name | Chun J Chang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003015462 PECOS PAC ID: 4082832886 Enrollment ID: I20140819002635 |
| Provider Name | Brent A Beaird |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003854738 PECOS PAC ID: 2365354669 Enrollment ID: I20160318000716 |
| Provider Name | Jason L Morris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992182141 PECOS PAC ID: 6709140015 Enrollment ID: I20180511002195 |
| Provider Name | Landon P Wood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528444023 PECOS PAC ID: 5799112538 Enrollment ID: I20200903002351 |
| Provider Name | Andrew Simmons |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013395011 PECOS PAC ID: 4385943539 Enrollment ID: I20201105002790 |
| Provider Name | Scott Gilmore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457705642 PECOS PAC ID: 8628360062 Enrollment ID: I20210524001233 |
| Provider Name | Alfred Fernandez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538696042 PECOS PAC ID: 8820365828 Enrollment ID: I20210720000668 |
| Provider Name | Cherie Terry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417933177 PECOS PAC ID: 4486624624 Enrollment ID: I20221115002844 |
Doty Family Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 29099 Hospital Road Suite 112, Lake Arrowhead, CA 92352 Phone: 909-337-3661 Fax: 909-337-3570 | |
Doty Family Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 29099 Hospital Rd, Ste 112, Lake Arrowhead, CA 92352 Phone: 909-337-3661 Fax: 909-337-3570 | |
Mountains Community Hospital Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 29099 Hospital Road, #200, Lake Arrowhead, CA 92352 Phone: 909-336-9715 Fax: 909-336-5751 | |
Martin Rocha Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 251 N Highway 173, Suite 6, Lake Arrowhead, CA 92321 Phone: 909-336-3670 Fax: 909-336-3674 |