| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 12/13/2023 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Medicare PECOS PAC ID | 9436501079 |
|---|---|
| Medicare Enrollment ID | O20240118002989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326816836 | NPI | - | NPPES |
| Provider Name | Stephen L Tam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689738478 PECOS PAC ID: 2567565492 Enrollment ID: I20070314000538 |
| Provider Name | Ma. Aleli D Malonzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194146811 PECOS PAC ID: 3870716814 Enrollment ID: I20140521000306 |
| Provider Name | Maria Luna Seguisabai Sabanico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821642810 PECOS PAC ID: 5395170955 Enrollment ID: I20200109000535 |
| Provider Name | Luzviminda Molina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346405248 PECOS PAC ID: 0143532028 Enrollment ID: I20210409001237 |
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