Organization
ELITE HEALTH PLAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GAIL MARIE BLACKLOCK CHC (CHIEF COMPLIANCE OFFICER)
(909) 630-2031
Entity
Organization
Contact information
Practice address
1131 W 6TH ST STE 255, ONTARIO, CA 91762-1117
(909) 630-2031
Mailing address
1131 W 6TH ST STE 255, ONTARIO, CA 91762-1117
(909) 630-2031
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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