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NPI Code Detail

MEDICARE: ANGELES MEDICAL CENTER LLC

MEDICARE: ANGELES MEDICAL CENTER LLC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1881411445
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGELES MEDICAL CENTER LLC
Provider Business Mailing Address
First Line : 2123 CIVIC CENTER DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-6327
Country : US
Telephone Number : 702-333-0110
Fax Number :
Provider Business Practice Location Address
First Line : 2123 CIVIC CENTER DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-6327
Country : US
Telephone Number : 702-333-0110
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : ALEJANDRA CEJA
Credential :
Telephone Number : 702-333-0110
Provider Enumeration Date : 09/24/2024
Last Update Date : 12/11/2025

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Directions to “ANGELES MEDICAL CENTER LLC ” Practice Location

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