Provider Demographics
NPI:1841841541
Name:ELITE MEDICAL GROUP LLC
Entity type:Organization
Organization Name:ELITE MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:NATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-509-9904
Mailing Address - Street 1:8687 W SAHARA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5869
Mailing Address - Country:US
Mailing Address - Phone:702-509-9904
Mailing Address - Fax:702-509-9921
Practice Address - Street 1:2170 E HARMON AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7840
Practice Address - Country:US
Practice Address - Phone:702-509-9904
Practice Address - Fax:702-509-9921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty