Provider Demographics
NPI:1881164754
Name:ELITE MEDICAL CARE INC
Entity type:Organization
Organization Name:ELITE MEDICAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LARAMIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-905-6487
Mailing Address - Street 1:1515 E ALLUVIAL AVE # 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3832
Mailing Address - Country:US
Mailing Address - Phone:559-250-8192
Mailing Address - Fax:
Practice Address - Street 1:1515 E ALLUVIAL AVE # 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3832
Practice Address - Country:US
Practice Address - Phone:559-250-8192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care