Organization
ELITE MD
Active
Organization
ELITE MD
Active
Other names
Elite Wound Care
Organization subpart
No
Provider details
NPI number
Authorized official
ELSIE JUMAO-AS (ADMINISTRATOR)
(702) 793-5280
Entity
Organization
Contact information
Practice address
2855 S BRONCO ST, LAS VEGAS, NV 89146-5207
(702) 730-0926
(702) 926-9658
Mailing address
2855 S BRONCO ST, LAS VEGAS, NV 89146-5207
(702) 329-9002
(702) 745-2182
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
04/15/2020
Last updated
01/27/2026
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