MEDICARE: VITUITY-NEVADA MEDICAL SERVICES KOURY & PARTNERS PC

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	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1669272183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITUITY-NEVADA MEDICAL SERVICES KOURY & PARTNERS PC

Provider Business Mailing Address
First Line	:	2100 POWELL ST STE 400
Second Line	:
City	:	EMERYVILLE
State	:	CA
Zip	:	94608-1872
Country	:	US
Telephone Number	:	510-851-7501
Fax Number	:

Provider Business Practice Location Address
First Line	:	6675 N DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4430
Country	:	US
Telephone Number	:	725-533-0400
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	DAVID BIRDSALL
Credential	:	MD
Telephone Number	:	510-350-2600

Provider Enumeration Date	:	03/14/2025
Last Update Date	:	03/14/2025

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