Provider Demographics
NPI:1457118705
Name:ELEVATE EMERGENCY MEDICINE
Entity Type:Organization
Organization Name:ELEVATE EMERGENCY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMEED
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGHAFI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-333-4376
Mailing Address - Street 1:41870 GARSTIN DR
Mailing Address - Street 2:
Mailing Address - City:BIG BEAR LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92315-2088
Mailing Address - Country:US
Mailing Address - Phone:858-333-4376
Mailing Address - Fax:
Practice Address - Street 1:41870 GARSTIN DR
Practice Address - Street 2:
Practice Address - City:BIG BEAR LAKE
Practice Address - State:CA
Practice Address - Zip Code:92315-2088
Practice Address - Country:US
Practice Address - Phone:858-333-4376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty