Organization
ELITE MEDICAL GROUP GP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY VAN SLYKE (CREDENTIALING)
(918) 809-2411
Entity
Organization
Contact information
Practice address
901 SAN BERNARDINO RD STE 300, UPLAND, CA 91786-7299
(918) 809-2411
Mailing address
901 SAN BERNARDINO RD STE 300, UPLAND, CA 91786-7299
(918) 809-2411
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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