| Southern Nevada Medical And Behavioral Group | |
|
1330 Karen Ave Unit B Las Vegas NV 89169-1260 | |
| (702) 239-9235 | |
| (702) 947-2287 |
| Full Name | Southern Nevada Medical And Behavioral Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 1330 Karen Ave Unit B, Las Vegas, Nevada |
| Authorized Official Name and Position | Marichu Pizan (CEO) |
| Authorized Official Contact | 7022399235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Nevada Medical And Behavioral Group 8854 Carradori Ave Las Vegas NV 89148-4940 Ph: (702) 239-9235 | Southern Nevada Medical And Behavioral Group 1330 Karen Ave Unit B Las Vegas NV 89169-1260 Ph: (702) 239-9235 |
| NPI Number | 1801485131 |
|---|---|
| Provider Enumeration Date | 01/12/2021 |
| Last Update Date | 02/18/2021 |
| Medicare PECOS PAC ID | 6507270667 |
|---|---|
| Medicare Enrollment ID | O20210201001385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801485131 | NPI | - | NPPES |
| 1801485131 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Anna Liza T Aguila |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295912830 PECOS PAC ID: 7618037755 Enrollment ID: I20081119000859 |
| Provider Name | Nauroz I Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356384325 PECOS PAC ID: 4486657731 Enrollment ID: I20100129000318 |
| Provider Name | Maria Zarina Diao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861732976 PECOS PAC ID: 6002051497 Enrollment ID: I20130410000225 |
| Provider Name | Marichu Pizan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497131668 PECOS PAC ID: 4880993856 Enrollment ID: I20160425002340 |
| Provider Name | Ronnie Valle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740723766 PECOS PAC ID: 6608150750 Enrollment ID: I20170309000369 |
| Provider Name | Noel Acebes Diao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306264353 PECOS PAC ID: 3072898469 Enrollment ID: I20170327002890 |
| Provider Name | Faith Marie Nepomuceno Unite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720505381 PECOS PAC ID: 4688735640 Enrollment ID: I20171127003353 |
| Provider Name | Reynaly Campos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154922300 PECOS PAC ID: 9032526017 Enrollment ID: I20210319000496 |
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