MEDICARE: DR. PEJMAN BADY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician	828	NV
2	207Q00000X	Family Medicine Physician	828	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00870033	OTHER	NV	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134146111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEJMAN BADY DO

Provider Business Mailing Address
First Line	:	PO BOX 6255
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89041-6255
Country	:	US
Telephone Number	:	702-984-6587
Fax Number	:	702-463-2894

Provider Business Practice Location Address
First Line	:	5741 S FORT APACHE RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5622
Country	:	US
Telephone Number	:	702-984-6587
Fax Number	:	866-496-8313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	10/21/2019

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Directions to “ DR. PEJMAN BADY DO” Practice Location

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