DIGESTIVE DISEASE CENTER NPI 1073621512

NPI Information

NPI: 1073621512
Provider Name: DIGESTIVE DISEASE CENTER
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 29D2026907

Address:
2136 E DESERT INN RD
SUITE B
LAS VEGAS, NV
ZIP 89109
Phone: (702) 734-0505
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DIGESTIVE DISEASE CENTER is an ambulatory surgical clinic center in Las Vegas, NV. DIGESTIVE DISEASE CENTER NPI is 1073621512. The provider is registered as an organization entity type.

The provider's business location address is:

2136 E DESERT INN RD
SUITE B
LAS VEGAS, NV
ZIP 89109-247
Phone: (702) 734-0505
Fax: (702) 734-3912

The provider's authorized official is Osama O. Haikal .
The authorized official title is Medical Director and has the following contact phone number (702) 734-0505.

The CLIA number assigned to this NPI record is 29D2026907 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/25/2006 and was last updated on 10/5/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	469ASC-8	NEVADA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	V9C0001018	MEDICARE PIN	NEVADA
2	004602010	MEDICAID	NEVADA
3	49002208	OTHER	NEVADA	RAILROAD MEDICARE

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: 4/28/2024

NPI Synchronization or Removal

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