| A Las Vegas Medical Group | |
|
5876 S. Pecos Rd. Bldg. B Las Vegas NV 89120 | |
| (702) 733-0744 | |
| (702) 796-8262 |
| Full Name | A Las Vegas Medical Group |
|---|---|
| Speciality | Pediatrics |
| Location | 5876 S. Pecos Rd. Bldg. B, Las Vegas, Nevada |
| Authorized Official Name and Position | Nikole Malaxechevarria (PRACTICE MANAGER) |
| Authorized Official Contact | 7027330744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Las Vegas Medical Group 5876 S. Pecos Rd. Bldg. B Las Vegas NV 89120 Ph: (702) 733-0744 | A Las Vegas Medical Group 5876 S. Pecos Rd. Bldg. B Las Vegas NV 89120 Ph: (702) 733-0744 |
| NPI Number | 1720324429 |
|---|---|
| Provider Enumeration Date | 12/27/2012 |
| Last Update Date | 07/22/2015 |
| Medicare PECOS PAC ID | 8426271255 |
|---|---|
| Medicare Enrollment ID | O20140523002213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720324429 | NPI | - | NPPES |
| 5234409 | Medicaid | NJ |
| Provider Name | Alan B Jauregui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972792075 PECOS PAC ID: 4082870001 Enrollment ID: I20120720000469 |
| Provider Name | Elmer S. David |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215019641 PECOS PAC ID: 9335362169 Enrollment ID: I20140523002221 |
| Provider Name | Elizabeth Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225574973 PECOS PAC ID: 9436420114 Enrollment ID: I20170731001700 |
| Provider Name | Hieu Truong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700326154 PECOS PAC ID: 4183995780 Enrollment ID: I20170731002990 |
| Provider Name | Jennifer Lyn Vidal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649565201 PECOS PAC ID: 8224397955 Enrollment ID: I20180125001508 |
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