| Elevate Md Services | |
|
16180 Dante Pl Fontana CA 92336-5952 | |
| (909) 434-5910 | |
| Not Available |
| Full Name | Elevate Md Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 16180 Dante Pl, Fontana, California |
| Authorized Official Name and Position | Cheyenne Chitry (CEO) |
| Authorized Official Contact | 9094345910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevate Md Services 16180 Dante Pl Fontana CA 92336-5952 Ph: (909) 434-5910 | Elevate Md Services 16180 Dante Pl Fontana CA 92336-5952 Ph: (909) 434-5910 |
| NPI Number | 1891569828 |
|---|---|
| Provider Enumeration Date | 11/09/2023 |
| Last Update Date | 11/09/2023 |
| Medicare PECOS PAC ID | 9436598562 |
|---|---|
| Medicare Enrollment ID | O20240422002045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891569828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sara H Ghazi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861816886 PECOS PAC ID: 8527376227 Enrollment ID: I20150929003505 |
| Provider Name | Joshua P Peloquin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831636083 PECOS PAC ID: 0749536381 Enrollment ID: I20180711003334 |
| Provider Name | Shireen Z Khalife |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962922393 PECOS PAC ID: 4789006164 Enrollment ID: I20200612002544 |
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