MEDICARE: J H DAULAT DO 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	207N00000X	Dermatology Physician	363	NV

General Provider Information

NPI Number	:	1821534983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J H DAULAT DO PC

Provider Business Mailing Address
First Line	:	9750 W SKYE CANYON PARK DR
Second Line	:	SUITE 160 #103
City	:	LAS VEGAS
State	:	NV
Zip	:	89166
Country	:	US
Telephone Number	:	702-683-1727
Fax Number	:	702-974-0440

Provider Business Practice Location Address
First Line	:	1420 E CALVADA BLVD
Second Line	:	STE 100
City	:	PAHRUMP
State	:	NV
Zip	:	89048-3974
Country	:	US
Telephone Number	:	757-270-9007
Fax Number	:	775-727-0902

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JALDEEP H DAULAT
Credential	:	DO
Telephone Number	:	702-654-3187

Provider Enumeration Date	:	01/13/2017
Last Update Date	:	12/28/2022

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