Healthcare Provider Details

I. General information

NPI: 1679080220
Provider Name (Legal Business Name): ONESOURCE SENIOR HEALTHCARE RANJBAR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 09/02/2025
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N RAINBOW BLVD STE 300
LAS VEGAS NV
89107-1061
US

IV. Provider business mailing address

16427 N SCOTTSDALE RD STE 410
SCOTTSDALE AZ
85254-7102
US

V. Phone/Fax

Practice location:
  • Phone: 888-495-4489
  • Fax: 702-537-9856
Mailing address:
  • Phone: 888-495-4489
  • Fax: 702-537-9856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: NATALIE N SHABA
Title or Position: OWNER
Credential:
Phone: 888-495-4489