| Elite Md | |
|
2855 S Bronco St Las Vegas NV 89146-5207 | |
| (702) 730-0926 | |
| (702) 926-9658 |
| Full Name | Elite Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 2855 S Bronco St, Las Vegas, Nevada |
| Authorized Official Name and Position | Vaughn Danao (ADMINISTRATOR) |
| Authorized Official Contact | 8182993110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Md 3349 Solento Ln Henderson NV 89044-1735 Ph: (818) 299-3110 | Elite Md 2855 S Bronco St Las Vegas NV 89146-5207 Ph: (702) 730-0926 |
| NPI Number | 1942829346 |
|---|---|
| Provider Enumeration Date | 04/15/2020 |
| Last Update Date | 08/25/2020 |
| Medicare PECOS PAC ID | 8527489756 |
|---|---|
| Medicare Enrollment ID | O20200526002540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942829346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Robby Ann Sembrano Quintos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417084542 PECOS PAC ID: 6507961471 Enrollment ID: I20080327000553 |
| Provider Name | Edsel Nunez Iway |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093097735 PECOS PAC ID: 3577783505 Enrollment ID: I20140925001152 |
| Provider Name | Anthony Brando Opimo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962057414 PECOS PAC ID: 7517299050 Enrollment ID: I20191101000838 |
| Provider Name | Maria Luna Seguisabai Sabanico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821642810 PECOS PAC ID: 5395170955 Enrollment ID: I20200109000535 |
| Provider Name | Kenneth R Ares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598372088 PECOS PAC ID: 5092125252 Enrollment ID: I20201029002645 |
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