| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 03/13/2023 |
| Last Update Date | 03/13/2023 |
| Certification Date | 03/13/2023 |
| Medicare PECOS PAC ID | 2062873433 |
|---|---|
| Medicare Enrollment ID | O20230801003578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154022523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Stephen L Tam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689738478 PECOS PAC ID: 2567565492 Enrollment ID: I20070314000538 |
| Provider Name | Linda W Sims |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427141738 PECOS PAC ID: 0143521575 Enrollment ID: I20151209000769 |
| Provider Name | Annette Kee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710248505 PECOS PAC ID: 2668736067 Enrollment ID: I20230113001571 |
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