Osteopathic Medical Associates Of Nevada | |
5410 W Sahara Ave Las Vegas NV 89146-3307 | |
(702) 362-2500 | |
(702) 876-6581 |
Full Name | Osteopathic Medical Associates Of Nevada |
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Speciality | Family Medicine |
Location | 5410 W Sahara Ave, Las Vegas, Nevada |
Authorized Official Name and Position | Leah Twist (CREDENTIALING) |
Authorized Official Contact | 7023622500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Osteopathic Medical Associates Of Nevada 5410 W Sahara Ave Las Vegas NV 89146-3307 Ph: (702) 362-2500 | Osteopathic Medical Associates Of Nevada 5410 W Sahara Ave Las Vegas NV 89146-3307 Ph: (702) 362-2500 |
NPI Number | 1841377157 |
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Provider Enumeration Date | 11/01/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 6800872771 |
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Medicare Enrollment ID | O20040629001639 |
Identifier | Type | State | Issuer |
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1841377157 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
Provider Name | Peter Joseph Licata |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1336225747 PECOS PAC ID: 2163615436 Enrollment ID: I20101019000700 |
Provider Name | George Gabriel Toldness |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720646045 PECOS PAC ID: 7416385075 Enrollment ID: I20200312001484 |
Provider Name | Charmaine Lou Coronado |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144860057 PECOS PAC ID: 4587087044 Enrollment ID: I20200701000754 |
Provider Name | Donna J Gould |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1902559313 PECOS PAC ID: 7618312109 Enrollment ID: I20240223001772 |
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