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FAMILY TREE MEDICAL CENTER LLC NPI 1508870445


NPI Information

NPI: 1508870445
Provider Name: FAMILY TREE MEDICAL CENTER LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 29D0998860

Address:
3510 E TROPICANA AVE
STE # K
LAS VEGAS, NV
ZIP 89121
Phone: (702) 947-1000
Get Directions

FAMILY TREE MEDICAL CENTER LLC is a family medicine in Las Vegas, NV. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FAMILY TREE MEDICAL CENTER LLC NPI is 1508870445. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3510 E TROPICANA AVE
STE # K
LAS VEGAS, NV
ZIP 89121-341
Phone: (702) 947-1000
Fax: (702) 947-1001

The provider's authorized official is Tony Gumina .
The authorized official title is Owner and has the following contact phone number (702) 947-1000.

The CLIA number assigned to this NPI record is 29D0998860 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 4/30/2013.


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
1207Q00000XFamily Medicine9897NEVADAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H49028MEDICARE UPINNEVADA
2002018528MEDICAIDNEVADA
3V38433MEDICARE ID-TYPE UNSPECIFIEDNEVADA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.