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Organization
ELITE MEDICAL GROUP OF SOUTHERN CALIFORNIA
Active
Organization
ELITE MEDICAL GROUP OF SOUTHERN CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAKER HILLAWY MD (OWNER)
(774) 444-1004
Entity
Organization
Contact information
Practice address
8816 FOOTHILL BLVD # 103-338, RANCHO CUCAMONGA, CA 91730-7199
(000) 000-0000
Mailing address
8816 FOOTHILL BLVD # 103-338, RANCHO CUCAMONGA, CA 91730-7199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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