CHILDRENS NEPHROLOGY CLINIC LLC NPI 1659541753

NPI Information

CHILDRENS NEPHROLOGY CLINIC, LLC is a specialist in Las Vegas, NV. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. CHILDRENS NEPHROLOGY CLINIC, LLC NPI is 1659541753. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3201 S MARYLAND PKWY
SUITE 606
LAS VEGAS, NV
ZIP 89109-441
Phone: (702) 639-1700
Fax: (702) 639-1717

The provider's authorized official is Michael O Aigbe .
The authorized official title is Owner and has the following contact phone number (702) 639-1700.

The CLIA number assigned to this NPI record is 29D1067198 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/4/2008 and was last updated on 3/4/2008.

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:

Other Identifiers

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

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