Elite Family Medical Center | |
1183 E Foothill Blvd Ste 135 Upland CA 91786-4082 | |
(909) 498-6293 | |
Not Available |
Full Name | Elite Family Medical Center |
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Speciality | Family Medicine |
Location | 1183 E Foothill Blvd Ste 135, Upland, California |
Authorized Official Name and Position | Maher I Danhash (OWNER) |
Authorized Official Contact | 9094986293 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Elite Family Medical Center 1183 E Foothill Blvd Ste 135 Upland CA 91786-4082 Ph: (909) 498-6293 | Elite Family Medical Center 1183 E Foothill Blvd Ste 135 Upland CA 91786-4082 Ph: (909) 498-6293 |
NPI Number | 1457020760 |
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Provider Enumeration Date | 09/09/2021 |
Last Update Date | 10/20/2021 |
Medicare PECOS PAC ID | 2567856438 |
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Medicare Enrollment ID | O20220219000051 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457020760 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
Provider Name | Maher Danhash |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689993313 PECOS PAC ID: 5597993097 Enrollment ID: I20140108000361 |
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