| Kristensen Festenese Medical Group Llc | |
|
8571 W Lake Mead Blvd #120 Las Vegas NV 89128 | |
| (702) 360-5194 | |
| Not Available |
| Full Name | Kristensen Festenese Medical Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8571 W Lake Mead Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Michael Salvatore Festenese (MANAGER) |
| Authorized Official Contact | 7023605194 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristensen Festenese Medical Group Llc 8571 W Lake Mead Blvd #120 Las Vegas NV 89128 Ph: (702) 360-5194 | Kristensen Festenese Medical Group Llc 8571 W Lake Mead Blvd #120 Las Vegas NV 89128 Ph: (702) 360-5194 |
| NPI Number | 1316033947 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1355374828 |
|---|---|
| Medicare Enrollment ID | O20050914001438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316033947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 1002760224 (Nevada) | Primary |
| Provider Name | Anne Elisa Kristensen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861499733 PECOS PAC ID: 7618900184 Enrollment ID: I20050915001225 |
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