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6240 N Durango Dr Ste 120 Las Vegas NV 89149-3941 | |
| (954) 923-7440 | |
| (954) 923-1299 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 6240 N Durango Dr Ste 120, Las Vegas, Nevada |
| Authorized Official Name and Position | Minghsun Liu (CEO) |
| Authorized Official Contact | 9549237440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
200 S Park Rd Ste 200 Hollywood FL 33021-8541 Ph: (954) 923-7440 | 6240 N Durango Dr Ste 120 Las Vegas NV 89149-3941 Ph: (954) 923-7440 |
| NPI Number | 1982002283 |
|---|---|
| Provider Enumeration Date | 12/18/2014 |
| Last Update Date | 05/05/2023 |
| Medicare PECOS PAC ID | 8820315047 |
|---|---|
| Medicare Enrollment ID | O20150327002039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982002283 | NPI | - | NPPES |
| 250001070 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| 208600000X | Surgery | 12469 (Nevada) | Secondary |
| Provider Name | Francis W Teng |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215088935 PECOS PAC ID: 5395644686 Enrollment ID: I20040106000480 |
| Provider Name | Pankaj K Bhatnagar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417929175 PECOS PAC ID: 4385724939 Enrollment ID: I20080424000578 |
| Provider Name | Brian Keith Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487114583 PECOS PAC ID: 7810221090 Enrollment ID: I20190621000022 |
| Provider Name | Jonard Y Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164905121 PECOS PAC ID: 0547696296 Enrollment ID: I20200129000535 |
| Provider Name | Jimmy Cruza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063079234 PECOS PAC ID: 9830527019 Enrollment ID: I20200323000562 |
| Provider Name | Joan Lou Paras Nakar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275172173 PECOS PAC ID: 0042554495 Enrollment ID: I20200706000181 |
| Provider Name | Jon Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316385529 PECOS PAC ID: 9032444740 Enrollment ID: I20200821000380 |
| Provider Name | Jackline H Duana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245752542 PECOS PAC ID: 2466726971 Enrollment ID: I20201130001804 |
| Provider Name | Mary Denisse Toribio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326649468 PECOS PAC ID: 9436563798 Enrollment ID: I20210127001774 |
| Provider Name | Kristine Mukuna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346852183 PECOS PAC ID: 8022427129 Enrollment ID: I20210430001578 |
| Provider Name | Rowell Sungcad Udalve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689320137 PECOS PAC ID: 6507245016 Enrollment ID: I20220613003182 |
| Provider Name | Minghsun Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518096270 PECOS PAC ID: 3577626803 Enrollment ID: I20230413001793 |
| Provider Name | Son T Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336834472 PECOS PAC ID: 9931568532 Enrollment ID: I20230629002266 |
| Provider Name | Larhonda Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689354383 PECOS PAC ID: 7416311485 Enrollment ID: I20230908001564 |
| Provider Name | Reynard C Nivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053790782 PECOS PAC ID: 4385959345 Enrollment ID: I20231218003224 |
| Provider Name | Irena Krass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871287748 PECOS PAC ID: 6002267820 Enrollment ID: I20240105002365 |
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