MEDICARE: WESTSIDE CARDIOLOGY

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	174400000X	Specialist	7780	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1255529590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTSIDE CARDIOLOGY

Provider Business Mailing Address
First Line	:	2800 N TENAYA WAY
Second Line	:	SUITE 202
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0652
Country	:	US
Telephone Number	:	702-255-8877
Fax Number	:	702-255-8813

Provider Business Practice Location Address
First Line	:	2800 N TENAYA WAY
Second Line	:	SUITE 202
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0652
Country	:	US
Telephone Number	:	702-255-8877
Fax Number	:	702-255-8813

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MARIE THERESE BILES
Credential	:
Telephone Number	:	702-255-8877

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	06/22/2012

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Directions to “WESTSIDE CARDIOLOGY ” Practice Location

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