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NPI Code Detail

MEDICARE: LAND GOLD

MEDICARE: LAND GOLD
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1427558766
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAND GOLD
Provider Business Mailing Address
First Line : 1700 E DESERT INN RD STE 314
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3207
Country : US
Telephone Number : 702-839-1088
Fax Number :
Provider Business Practice Location Address
First Line : 1700 E DESERT INN RD STE 314
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3207
Country : US
Telephone Number : 702-839-1088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2018
Last Update Date : 02/13/2018

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Directions to “ LAND GOLD ” Practice Location

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