| Shahab Mokhtare Inc | |
|
851 S Rampart Blvd 220 Las Vegas NV 89145-4882 | |
| (702) 420-7704 | |
| Not Available |
| Full Name | Shahab Mokhtare Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 851 S Rampart Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Shahab Mokhtare (OWNER) |
| Authorized Official Contact | 7024207704 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shahab Mokhtare Inc 410 S Rampart Blvd Ste 420 Las Vegas NV 89145-5749 Ph: (702) 420-7704 | Shahab Mokhtare Inc 851 S Rampart Blvd 220 Las Vegas NV 89145-4882 Ph: (702) 420-7704 |
| NPI Number | 1639576820 |
|---|---|
| Provider Enumeration Date | 12/03/2014 |
| Last Update Date | 11/01/2021 |
| Medicare PECOS PAC ID | 3274857065 |
|---|---|
| Medicare Enrollment ID | O20150127001853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639576820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 13663 (Nevada) | Primary |
| Provider Name | Shahab Mokhtare |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093913378 PECOS PAC ID: 7012170269 Enrollment ID: I20120525000154 |
| Provider Name | Meilan Liang Daguman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083089874 PECOS PAC ID: 2961703574 Enrollment ID: I20160229000756 |
| Provider Name | Monica L Byers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225045354 PECOS PAC ID: 7416842042 Enrollment ID: I20161118002256 |
| Provider Name | Arion Shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982159638 PECOS PAC ID: 3072882216 Enrollment ID: I20170703001881 |
| Provider Name | Eun Ae Sung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366971194 PECOS PAC ID: 3173887890 Enrollment ID: I20180504002057 |
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