| Prasad-leela Llc | |
|
3416 N Buffalo Dr Las Vegas NV 89129-7424 | |
| (702) 341-6699 | |
| (702) 341-6968 |
| Full Name | Prasad-leela Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3416 N Buffalo Dr, Las Vegas, Nevada |
| Authorized Official Name and Position | Gopalakrishna Iyengar Leela (OWNER) |
| Authorized Official Contact | 7023416699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prasad-leela Llc 3022 S Durango Dr Ste 100 Las Vegas NV 89117-4440 Ph: (702) 341-6699 | Prasad-leela Llc 3416 N Buffalo Dr Las Vegas NV 89129-7424 Ph: (702) 341-6699 |
| NPI Number | 1629187885 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 09/14/2023 |
| Medicare PECOS PAC ID | 5890711907 |
|---|---|
| Medicare Enrollment ID | O20090824000586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629187885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 11458 (Nevada) | Primary |
| Provider Name | Gopalakrishna Iyengar Leela |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609859305 PECOS PAC ID: 2163448127 Enrollment ID: I20051019000203 |
| Provider Name | Maria Zarina Diao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861732976 PECOS PAC ID: 6002051497 Enrollment ID: I20130410000225 |
| Provider Name | Catherine Blakeslee Lorentz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669919742 PECOS PAC ID: 8820372899 Enrollment ID: I20170313000695 |
| Provider Name | Gloria Santiaguel Mandel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528566460 PECOS PAC ID: 0143582965 Enrollment ID: I20180314002391 |
| Provider Name | Victor John Pascual Barcarse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629646286 PECOS PAC ID: 8729465315 Enrollment ID: I20220520000865 |
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