| Im Locum Llc | |
|
1025 S 2nd Ave Walla Walla WA 99362-4116 | |
| (702) 453-3799 | |
| (702) 453-5741 |
| Full Name | Im Locum Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1025 S 2nd Ave, Walla Walla, Washington |
| Authorized Official Name and Position | Brian Nguyen (SOLE OWNER) |
| Authorized Official Contact | 7142305151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Im Locum Llc 1516 E Tropicana Ave Ste 155 Las Vegas NV 89119-8316 Ph: (702) 453-3799 | Im Locum Llc 1025 S 2nd Ave Walla Walla WA 99362-4116 Ph: (702) 453-3799 |
| NPI Number | 1053787747 |
|---|---|
| Provider Enumeration Date | 08/17/2015 |
| Last Update Date | 08/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053787747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD60475120 (Washington) | Primary |
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