MEDICARE: KEVIN REFAHIYAT PA

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	363AM0700X	Medical Physician Assistant	1940	NV

General Provider Information

NPI Number	:	1386145159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN REFAHIYAT PA

Provider Business Mailing Address
First Line	:	7150 S DURANGO DR STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2242
Country	:	US
Telephone Number	:	801-668-5827
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 S DURANGO DR STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2242
Country	:	US
Telephone Number	:	702-677-3351
Fax Number	:

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

Provider Enumeration Date	:	02/26/2018
Last Update Date	:	03/20/2020

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Directions to “ KEVIN REFAHIYAT PA” Practice Location

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