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Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical

Provider NPI: 1669585964

Organization Information:
Organization is not Subpart
Authorized Official:  FAY  DELA CRUZ  ADMINISTRATOR  702-675-4600

Practice Location:
Tel: 702-675-4600  Fax: 702-675-4604

Business Mailing Address:
Tel: 702-675-4600  Fax: 702-675-4604

NPI Information:
NPI: 1669585964
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y261QA1903XAmbulatory Health Care Facilities
Ambulatory Surgical

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 261QA1903X





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