| Canyon Gate Medical Group, Llc | |
|
10155 W Twain Ave Suite # 110 Las Vegas NV 89147-6722 | |
| (702) 243-2689 | |
| (702) 243-2632 |
| Full Name | Canyon Gate Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10155 W Twain Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Ricki Moskow (PRESIDENT) |
| Authorized Official Contact | 9546568855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Gate Medical Group, Llc 2929 N University Dr Suite # 110 Coral Springs FL 33065-5081 Ph: (954) 656-8855 | Canyon Gate Medical Group, Llc 10155 W Twain Ave Suite # 110 Las Vegas NV 89147-6722 Ph: (702) 243-2689 |
| NPI Number | 1013249788 |
|---|---|
| Provider Enumeration Date | 02/05/2010 |
| Last Update Date | 02/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013249788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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