Goldwyn Integrated Medical Group Inc | |
2785 E Desert Inn Rd Ste 150 Las Vegas NV 89121-3699 | |
(760) 220-1991 | |
Not Available |
Full Name | Goldwyn Integrated Medical Group Inc |
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Speciality | General Practice |
Location | 2785 E Desert Inn Rd Ste 150, Las Vegas, Nevada |
Authorized Official Name and Position | Isabelle Sabalones (PRESIDENT) |
Authorized Official Contact | 7602201991 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Goldwyn Integrated Medical Group Inc 2785 E Desert Inn Rd Ste 150 Las Vegas NV 89121-3699 Ph: (760) 220-1991 | Goldwyn Integrated Medical Group Inc 2785 E Desert Inn Rd Ste 150 Las Vegas NV 89121-3699 Ph: (760) 220-1991 |
NPI Number | 1326816836 |
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Provider Enumeration Date | 12/13/2023 |
Last Update Date | 12/13/2023 |
Certification Date | 12/13/2023 |
Medicare PECOS PAC ID | 9436501079 |
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Medicare Enrollment ID | O20240118002989 |
Identifier | Type | State | Issuer |
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1326816836 | NPI | - | NPPES |
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 | Maria Luna Seguisabai Sabanico |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821642810 PECOS PAC ID: 5395170955 Enrollment ID: I20200109000535 |
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