| Medical Group Llc | |
|
9315 W Sunset Rd Suite 100 Las Vegas NV 89148-5011 | |
| (702) 638-7705 | |
| (702) 638-7706 |
| Full Name | Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9315 W Sunset Rd, Las Vegas, Nevada |
| Authorized Official Name and Position | Roland Jayson Pua (OWNER) |
| Authorized Official Contact | 7026387705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Group Llc 9315 W Sunset Rd Suite 100 Las Vegas NV 89148-5011 Ph: (702) 638-7705 | Medical Group Llc 9315 W Sunset Rd Suite 100 Las Vegas NV 89148-5011 Ph: (702) 638-7705 |
| NPI Number | 1366681538 |
|---|---|
| Provider Enumeration Date | 02/11/2009 |
| Last Update Date | 10/07/2016 |
| Medicare PECOS PAC ID | 3072669183 |
|---|---|
| Medicare Enrollment ID | O20090915000257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366681538 | NPI | - | NPPES |
| 207RG0600X | Other | TAXONOMY | |
| 100511248 | Medicaid | NV | |
| 1215009782 | Other | NV | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 12103 (Nevada) | Primary |
| Provider Name | Roland Pua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215009782 PECOS PAC ID: 2961403035 Enrollment ID: I20070117000107 |
| Provider Name | Maria Cristina Pajara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205275500 PECOS PAC ID: 5991931008 Enrollment ID: I20131120000766 |
| Provider Name | Belinda Orden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902150840 PECOS PAC ID: 6800010224 Enrollment ID: I20140604002340 |
| Provider Name | Lalaine Villahermosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699333682 PECOS PAC ID: 5092147439 Enrollment ID: I20230224002525 |
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