# ELITE HEALTH PLAN, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053134098
- **Authorized official:** MS. GAIL MARIE BLACKLOCK CHC (CHIEF COMPLIANCE OFFICER)
- **Authorized official phone:** (909) 630-2031

## Contact information

- **Practice address:** 1131 W 6TH ST STE 255, ONTARIO, CA 91762-1117
- **Practice address phone:** (909) 630-2031
- **Mailing address:** 1131 W 6TH ST STE 255, ONTARIO, CA 91762-1117
- **Mailing address phone:** (909) 630-2031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 11/07/2024
- **Last updated:** 11/07/2024