SOUTHERN NEVADA MEDICAL & PEDIATRICS ASSOCIATES LLC NPI 1093230138

NPI Information

NPI: 1093230138
Provider Name: SOUTHERN NEVADA MEDICAL & PEDIATRICS ASSOCIATES LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 29D2066059

Address:
3301 W CHARLESTON BLVD
LAS VEGAS, NV
ZIP 89102
Phone: (702) 968-0100
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SOUTHERN NEVADA MEDICAL & PEDIATRICS ASSOCIATES LLC is a primary care clinic center in Las Vegas, NV. SOUTHERN NEVADA MEDICAL & PEDIATRICS ASSOCIATES LLC NPI is 1093230138. The provider is registered as an organization entity type.

The provider's business location address is:

3301 W CHARLESTON BLVD
LAS VEGAS, NV
ZIP 89102-835
Phone: (702) 968-0100
Fax: (702) 968-0104

The provider's authorized official is Camilo Tabora .
The authorized official title is Managing Partner and has the following contact phone number (702) 968-0100.

The CLIA number assigned to this NPI record is 29D2066059 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/10/2017 and was last updated on 7/21/2022.

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	261QP2300X	Clinic/Center	Primary Care	9691	NEVADA	Yes

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

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