Provider Demographics
NPI:1710333976
Name:ELITE FIRST HEALTH
Entity Type:Organization
Organization Name:ELITE FIRST HEALTH
Other - Org Name:FIRST ELITE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GIFTY
Authorized Official - Middle Name:
Authorized Official - Last Name:AIDOO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:209-484-0951
Mailing Address - Street 1:PO BOX 576810
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-6810
Mailing Address - Country:US
Mailing Address - Phone:209-484-0951
Mailing Address - Fax:
Practice Address - Street 1:3121 YOSEMITE BLVD STE D2
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354
Practice Address - Country:US
Practice Address - Phone:206-566-9366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21215261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care