| Good Samaritan Llc | |
|
3201 S Maryland Pkwy Tower 1 Suite 314 Las Vegas NV 89109-2425 | |
| (702) 325-9652 | |
| Not Available |
| Full Name | Good Samaritan Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3201 S Maryland Pkwy, Las Vegas, Nevada |
| Authorized Official Name and Position | Shaun E Jang (OWNER) |
| Authorized Official Contact | 7022753451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Samaritan Llc 3201 S Maryland Pkwy Tower 1 Suite 314 Las Vegas NV 89109-2425 Ph: () - | Good Samaritan Llc 3201 S Maryland Pkwy Tower 1 Suite 314 Las Vegas NV 89109-2425 Ph: (702) 325-9652 |
| NPI Number | 1528607512 |
|---|---|
| Provider Enumeration Date | 12/23/2019 |
| Last Update Date | 11/10/2020 |
| Medicare PECOS PAC ID | 7618306911 |
|---|---|
| Medicare Enrollment ID | O20200408001925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528607512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Tristan Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962803635 PECOS PAC ID: 5890917355 Enrollment ID: I20141118000569 |
| Provider Name | Shaun Jang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619111531 PECOS PAC ID: 0244481984 Enrollment ID: I20150309001131 |
| Provider Name | Annette Asbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659812212 PECOS PAC ID: 8628345295 Enrollment ID: I20180730001554 |
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