| Vista Medical Associates Llc | |
|
2909 W Charleston Blvd Las Vegas NV 89102-1925 | |
| (702) 798-1233 | |
| (702) 531-1233 |
| Full Name | Vista Medical Associates Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2909 W Charleston Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Kofi E Sarfo (PRESIDENT) |
| Authorized Official Contact | 7027981233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Medical Associates Llc Po Box 365404 N Las Vegas NV 89036-9404 Ph: (702) 798-1233 | Vista Medical Associates Llc 2909 W Charleston Blvd Las Vegas NV 89102-1925 Ph: (702) 798-1233 |
| NPI Number | 1962403121 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 10/24/2018 |
| Medicare PECOS PAC ID | 1153353750 |
|---|---|
| Medicare Enrollment ID | O20050902000710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962403121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11205 (Nevada) | Primary |
| Provider Name | Kofi E Sarfo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881695609 PECOS PAC ID: 2365493483 Enrollment ID: I20050217000134 |
| Provider Name | Beatrice Mary Blay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053830430 PECOS PAC ID: 1254690944 Enrollment ID: I20180126000606 |
| Provider Name | Julio Arvie Mata Madarazo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144828849 PECOS PAC ID: 7810304110 Enrollment ID: I20210405000814 |
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