1st Clark County Medical Clinic Llc | |
3430 E Flamingo Rd Ste 320 Las Vegas NV 89121-5067 | |
(702) 485-3450 | |
Not Available |
Full Name | 1st Clark County Medical Clinic Llc |
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Speciality | General Practice |
Location | 3430 E Flamingo Rd Ste 320, Las Vegas, Nevada |
Authorized Official Name and Position | Chris Jacinto (CEO) |
Authorized Official Contact | 5104568143 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1st Clark County Medical Clinic Llc 3430 E Flamingo Rd Ste 320 Las Vegas NV 89121-5067 Ph: (702) 485-3450 | 1st Clark County Medical Clinic Llc 3430 E Flamingo Rd Ste 320 Las Vegas NV 89121-5067 Ph: (702) 485-3450 |
NPI Number | 1154022523 |
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Provider Enumeration Date | 03/13/2023 |
Last Update Date | 03/13/2023 |
Certification Date | 03/13/2023 |
Medicare PECOS PAC ID | 2062873433 |
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Medicare Enrollment ID | O20230801003578 |
Identifier | Type | State | Issuer |
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1154022523 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Stephen L Tam |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1689738478 PECOS PAC ID: 2567565492 Enrollment ID: I20070314000538 |
Provider Name | Annette Kee |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710248505 PECOS PAC ID: 2668736067 Enrollment ID: I20230113001571 |
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