| Choice Family Medical Clinic Llc | |
|
4185 Vegas Valley Dr Ste C Las Vegas NV 89121-2522 | |
| (702) 463-9066 | |
| (702) 463-9067 |
| Full Name | Choice Family Medical Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4185 Vegas Valley Dr Ste C, Las Vegas, Nevada |
| Authorized Official Name and Position | Letaniya Warren Tatum (OWNER) |
| Authorized Official Contact | 7026800600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Choice Family Medical Clinic Llc 400 N Stephanie St Ste 260 Henderson NV 89014-6800 Ph: (702) 629-5555 | Choice Family Medical Clinic Llc 4185 Vegas Valley Dr Ste C Las Vegas NV 89121-2522 Ph: (702) 463-9066 |
| NPI Number | 1538778634 |
|---|---|
| Provider Enumeration Date | 07/24/2020 |
| Last Update Date | 04/06/2022 |
| Medicare PECOS PAC ID | 6204249931 |
|---|---|
| Medicare Enrollment ID | O20210119001648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538778634 | NPI | - | NPPES |
| 2500010169 | Medicaid | NV | |
| NV20201837431 | Other | NV | STATE OF NEVADA |
| Provider Name | Pamela Lynn Stclair |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467575332 PECOS PAC ID: 5799194957 Enrollment ID: I20210429002502 |
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