| Heart Medical Group | |
|
1210 S Valley View Blvd Unit 102 Las Vegas NV 89102 | |
| (702) 235-5778 | |
| Not Available |
| Full Name | Heart Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 1210 S Valley View Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Vivian Owyong (AGENT) |
| Authorized Official Contact | 7022355778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Medical Group 1210 S Valley View Blvd Unit 102 Las Vegas NV 89102 Ph: (702) 235-5778 | Heart Medical Group 1210 S Valley View Blvd Unit 102 Las Vegas NV 89102 Ph: (702) 235-5778 |
| NPI Number | 1962050716 |
|---|---|
| Provider Enumeration Date | 08/26/2019 |
| Last Update Date | 12/30/2019 |
| Medicare PECOS PAC ID | 8527496512 |
|---|---|
| Medicare Enrollment ID | O20200325003402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962050716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | (* (Not Available)) | Primary |
| Provider Name | Ida Sorongon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700225844 PECOS PAC ID: 7719100700 Enrollment ID: I20140520001236 |
| Provider Name | Mariliza Ilagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114316320 PECOS PAC ID: 1254636970 Enrollment ID: I20170616001406 |
| Provider Name | Dithra Ann Cotton-lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487159182 PECOS PAC ID: 0749539161 Enrollment ID: I20180817002985 |
| Provider Name | Hillary Habiger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780074153 PECOS PAC ID: 7113148800 Enrollment ID: I20190830002758 |
| Provider Name | Nemia V Chiang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851872055 PECOS PAC ID: 6002248481 Enrollment ID: I20191125000680 |
| Provider Name | Elsie Creason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033611793 PECOS PAC ID: 9133541188 Enrollment ID: I20200629003755 |
| Provider Name | Shellie Aparicio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306471677 PECOS PAC ID: 7618393224 Enrollment ID: I20200813001149 |
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