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Organization
ELEVATE SENIORS PC
Active
Organization
ELEVATE SENIORS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER SIMMONS MD (OWNER)
(480) 398-5555
Entity
Organization
Contact information
Practice address
6800 LINCOLN AVE, STE 204, BUENA PARK, CA 90620-4162
(866) 888-7078
Mailing address
6800 LINCOLN AVE, STE 204, BUENA PARK, CA 90620-4162
(866) 888-7078
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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