| Sagebrush Medical Center, Llc | |
|
3097 E Warm Springs Rd Ste 400 Las Vegas NV 89120-3757 | |
| (702) 790-2211 | |
| (702) 790-2316 |
| Full Name | Sagebrush Medical Center, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3097 E Warm Springs Rd Ste 400, Las Vegas, Nevada |
| Authorized Official Name and Position | Harry Pan (MANAGER) |
| Authorized Official Contact | 7027902211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sagebrush Medical Center, Llc 3097 E Warm Springs Rd Ste 400 Las Vegas NV 89120-3757 Ph: (702) 790-2211 | Sagebrush Medical Center, Llc 3097 E Warm Springs Rd Ste 400 Las Vegas NV 89120-3757 Ph: (702) 790-2211 |
| NPI Number | 1053865840 |
|---|---|
| Provider Enumeration Date | 08/09/2016 |
| Last Update Date | 07/11/2024 |
| Medicare PECOS PAC ID | 6901187020 |
|---|---|
| Medicare Enrollment ID | O20170104001656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053865840 | NPI | - | NPPES |
| 81214000 | Other | TAX ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | DO2007 (Nevada) | Primary |
| Provider Name | Harry S Pan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346688538 PECOS PAC ID: 5092031286 Enrollment ID: I20160706002135 |
| Provider Name | Joseph Lau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619438389 PECOS PAC ID: 3971846130 Enrollment ID: I20190510001483 |
| Provider Name | Sonia M Garcia Jayne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679922959 PECOS PAC ID: 7517252497 Enrollment ID: I20190716002096 |
| Provider Name | Daniel Sam Sandoval Acierto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528670866 PECOS PAC ID: 3577980804 Enrollment ID: I20200901000600 |
| Provider Name | Joshua Valera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831842830 PECOS PAC ID: 0446643423 Enrollment ID: I20220216000377 |
| Provider Name | Jhaunden P Concepcion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225667520 PECOS PAC ID: 0547684458 Enrollment ID: I20231024002400 |
| Provider Name | Michele Anne Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346011640 PECOS PAC ID: 2860845443 Enrollment ID: I20240131000406 |
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