Healthcare Provider Details

I. General information

NPI: 1497873475
Provider Name (Legal Business Name): DESERT PINES FAMILY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 W CHEYENNE AVE
LAS VEGAS NV
89108-4590
US

IV. Provider business mailing address

6800 W CHEYENNE AVE
LAS VEGAS NV
89108-4590
US

V. Phone/Fax

Practice location:
  • Phone: 702-658-8800
  • Fax:
Mailing address:
  • Phone: 702-658-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS B HERMANSEN
Title or Position: OWNER
Credential: D.C.
Phone: 702-658-8800