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BAMBOO FAMILY CLINIC LLC NPI 1881196012


NPI Information

NPI: 1881196012
Provider Name: BAMBOO FAMILY CLINIC LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 29D2174652

Address:
98 E LAKE MEAD PKWY STE 307
HENDERSON, NV
ZIP 89015
Phone: (702) 433-3038
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BAMBOO FAMILY CLINIC LLC is a pediatrics in Henderson, NV. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. BAMBOO FAMILY CLINIC LLC NPI is 1881196012. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

98 E LAKE MEAD PKWY STE 307
HENDERSON, NV
ZIP 89015-444
Phone: (702) 433-3038
Fax: (702) 949-1975

The provider's authorized official is Shirley Holdeman .
The authorized official title is Owner and has the following contact phone number (702) 433-3038.

The CLIA number assigned to this NPI record is 29D2174652 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/3/2018 and was last updated on 3/3/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes
2261Q00000XClinic/CenterNo
3261QP2300XClinic/CenterPrimary CareNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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