MEDICARE: KIDNEY DIALYSIS AND HYPERTENSION SPECIALISTS

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	207RN0300X	Nephrology Physician	13114	NV

General Provider Information

NPI Number	:	1467728097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDNEY DIALYSIS AND HYPERTENSION SPECIALISTS

Provider Business Mailing Address
First Line	:	PO BOX 370494
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89137-0494
Country	:	US
Telephone Number	:	646-285-8836
Fax Number	:

Provider Business Practice Location Address
First Line	:	7908 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1990
Country	:	US
Telephone Number	:	702-600-8086
Fax Number	:	866-606-0690

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LUANA PILLON
Credential	:	M.D.
Telephone Number	:	646-285-8836

Provider Enumeration Date	:	03/28/2012
Last Update Date	:	01/04/2020

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