Healthcare Provider Details

I. General information

NPI: 1902826464
Provider Name (Legal Business Name): POUYA MOHAJER MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5741 S FORT APACHE RD STE 120
LAS VEGAS NV
89148-5622
US

IV. Provider business mailing address

5130 S FORT APACHE RD STE 215
LAS VEGAS NV
89148-1732
US

V. Phone/Fax

Practice location:
  • Phone: 702-798-0111
  • Fax: 866-333-0436
Mailing address:
  • Phone: 702-798-0111
  • Fax: 866-333-0436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: POUYA MOHAJER
Title or Position: PRESIDENT
Credential: MD
Phone: 702-798-0111