Las Vegas Mobile Medical Group Pc | |
9017 S Pecos Rd Ste 4540 Henderson NV 89074-6604 | |
(626) 347-8548 | |
Not Available |
Full Name | Las Vegas Mobile Medical Group Pc |
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Speciality | Family Medicine |
Location | 9017 S Pecos Rd Ste 4540, Henderson, Nevada |
Authorized Official Name and Position | Shylee Tiamson (OWNER/AUTHORIZED OFFICIAL) |
Authorized Official Contact | 6263478548 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Las Vegas Mobile Medical Group Pc 9017 S Pecos Rd Ste 4540 Henderson NV 89074-6604 Ph: () - | Las Vegas Mobile Medical Group Pc 9017 S Pecos Rd Ste 4540 Henderson NV 89074-6604 Ph: (626) 347-8548 |
NPI Number | 1144090770 |
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Provider Enumeration Date | 01/04/2024 |
Last Update Date | 01/04/2024 |
Medicare PECOS PAC ID | 4385080969 |
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Medicare Enrollment ID | O20240306002781 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144090770 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Carlota Barde Cinco |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891336301 PECOS PAC ID: 2264669290 Enrollment ID: I20210108001965 |
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