| Leo Gan-lim, M.d., Prof Corp | |
|
653 N Town Center Dr Ste 101 Las Vegas NV 89144-0515 | |
| (702) 485-2791 | |
| (702) 485-2812 |
| Full Name | Leo Gan-lim, M.d., Prof Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 653 N Town Center Dr Ste 101, Las Vegas, Nevada |
| Authorized Official Name and Position | Leonardo Gan-lim (MANAGING MEMBER) |
| Authorized Official Contact | 7024612707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leo Gan-lim, M.d., Prof Corp 2654 Topaz Blue St Las Vegas NV 89146-5490 Ph: () - | Leo Gan-lim, M.d., Prof Corp 653 N Town Center Dr Ste 101 Las Vegas NV 89144-0515 Ph: (702) 485-2791 |
| NPI Number | 1093322158 |
|---|---|
| Provider Enumeration Date | 09/23/2020 |
| Last Update Date | 08/15/2023 |
| Medicare PECOS PAC ID | 5395165971 |
|---|---|
| Medicare Enrollment ID | O20201020002912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093322158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Leonardo A Gan-lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134180839 PECOS PAC ID: 3173511912 Enrollment ID: I20040726000938 |
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