Organization
ELITE MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH HIGHSHAW MD (OWNER)
(828) 719-5658
Entity
Organization
Contact information
Practice address
2083 COMPTON AVE STE 202, CORONA, CA 92881-3416
(951) 268-5600
Mailing address
17748 SKY PARK CIR STE 240, IRVINE, CA 92614-4472
(828) 719-5658
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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