| Mind Power Medical Group | |
|
8565 S Eastern Ave Ste 150 Las Vegas NV 89123 | |
| (818) 932-4684 | |
| (888) 277-1901 |
| Full Name | Mind Power Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 8565 S Eastern Ave Ste 150, Las Vegas, Nevada |
| Authorized Official Name and Position | Cristine Hernandez (CEO) |
| Authorized Official Contact | 8189324684 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Power Medical Group 8565 S Eastern Ave Ste 150 Las Vegas NV 89123-2906 Ph: (818) 932-4684 | Mind Power Medical Group 8565 S Eastern Ave Ste 150 Las Vegas NV 89123 Ph: (818) 932-4684 |
| NPI Number | 1851871768 |
|---|---|
| Provider Enumeration Date | 08/20/2018 |
| Last Update Date | 08/20/2018 |
| Medicare PECOS PAC ID | 5890046916 |
|---|---|
| Medicare Enrollment ID | O20180927003094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851871768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (Nevada) | Primary |
| 363L00000X | Nurse Practitioner | (Nevada) | Secondary |
| Provider Name | Jacqueline J Leventhal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245494731 PECOS PAC ID: 2163417445 Enrollment ID: I20040416000517 |
| Provider Name | Daniel Sussman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275575870 PECOS PAC ID: 7214832179 Enrollment ID: I20040625000223 |
| Provider Name | Beverly Driskill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689762122 PECOS PAC ID: 0042303075 Enrollment ID: I20070907000392 |
| Provider Name | Alan B Jauregui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972792075 PECOS PAC ID: 4082870001 Enrollment ID: I20120720000469 |
| Provider Name | Cesar S Estillore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649517970 PECOS PAC ID: 9739252180 Enrollment ID: I20130530000507 |
| Provider Name | Enrico Estrella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033506498 PECOS PAC ID: 8527376334 Enrollment ID: I20150928002793 |
| Provider Name | Edward Fenn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023274768 PECOS PAC ID: 7517254188 Enrollment ID: I20160926000644 |
| Provider Name | Ajumobi C Agu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336453927 PECOS PAC ID: 9638446545 Enrollment ID: I20170525000225 |
| Provider Name | Tiffany Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730683319 PECOS PAC ID: 5193087443 Enrollment ID: I20180326001149 |
| Provider Name | Gerald Lynn Gibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700441094 PECOS PAC ID: 4880923119 Enrollment ID: I20190911001044 |
| Provider Name | Ernesto J Isman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326535683 PECOS PAC ID: 9638408792 Enrollment ID: I20190916000816 |
| Provider Name | Atheni Degrano Sevilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215104377 PECOS PAC ID: 5294160990 Enrollment ID: I20200126000039 |
| Provider Name | Raymond F O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144472770 PECOS PAC ID: 6002245693 Enrollment ID: I20200402001112 |
| Provider Name | Mario Antonio Pacada |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114982535 PECOS PAC ID: 6901813591 Enrollment ID: I20210421001822 |
| Provider Name | Sheena Marie Spanskie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275179657 PECOS PAC ID: 6204238298 Enrollment ID: I20210713003869 |
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