| Innovative Care Physicians | |
|
5506 S Fort Apache Rd Ste 100 Las Vegas NV 89148-7673 | |
| (702) 533-4484 | |
| Not Available |
| Full Name | Innovative Care Physicians |
|---|---|
| Speciality | Internal Medicine |
| Location | 5506 S Fort Apache Rd Ste 100, Las Vegas, Nevada |
| Authorized Official Name and Position | Ivan Goldsmith (OWNER) |
| Authorized Official Contact | 7029605762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Care Physicians 5375 S Fort Apache Rd Ste 102 Las Vegas NV 89148-7624 Ph: () - | Innovative Care Physicians 5506 S Fort Apache Rd Ste 100 Las Vegas NV 89148-7673 Ph: (702) 533-4484 |
| NPI Number | 1235843608 |
|---|---|
| Provider Enumeration Date | 01/10/2023 |
| Last Update Date | 01/16/2023 |
| Medicare PECOS PAC ID | 1052782059 |
|---|---|
| Medicare Enrollment ID | O20230131001348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235843608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ivan Goldsmith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073614095 PECOS PAC ID: 1052572294 Enrollment ID: I20120413000574 |
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