| Vista Family Medicine Llc | |
|
4834 Sparks Blvd Suite 100 Sparks NV 89436-8215 | |
| (775) 356-8100 | |
| (775) 356-8101 |
| Full Name | Vista Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4834 Sparks Blvd, Sparks, Nevada |
| Authorized Official Name and Position | Hyun Hong (MANAGING MEMBER) |
| Authorized Official Contact | 7753568100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Family Medicine Llc 4834 Sparks Blvd Suite 100 Sparks NV 89436-8215 Ph: (775) 356-8100 | Vista Family Medicine Llc 4834 Sparks Blvd Suite 100 Sparks NV 89436-8215 Ph: (775) 356-8100 |
| NPI Number | 1700102464 |
|---|---|
| Provider Enumeration Date | 04/20/2010 |
| Last Update Date | 08/03/2021 |
| Medicare PECOS PAC ID | 6204028814 |
|---|---|
| Medicare Enrollment ID | O20101013001247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700102464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9830 (Nevada) | Primary |
| Provider Name | Hyun J Hong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083691927 PECOS PAC ID: 0345265955 Enrollment ID: I20051012001202 |
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