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Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical

Provider NPI: 1801192059

Organization Information:
Organization is not Subpart
Authorized Official:  CATHERINE L MCDONALD  PRACTICE MANAGER  702-262-0079

Practice Location:
9120 W RUSSELL RD SUITE #100 LAS VEGAS, NV 89148-1229 US
Tel: 702-476-2897  Fax: 702-685-6910

Business Mailing Address:
9120 W RUSSELL RD SUITE #100 LAS VEGAS, NV 89148-1229 US
Tel: 702-476-2897  Fax: 702-685-6910

NPI Information:
NPI: 1801192059
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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