Healthcare Provider Details

I. General information

NPI: 1194896894
Provider Name (Legal Business Name): CENTER EMERGENCY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 N TOWN CENTER DR
LAS VEGAS NV
89144-6367
US

IV. Provider business mailing address

3916 STATE ST #300
SANTA BARBARA CA
93105-5602
US

V. Phone/Fax

Practice location:
  • Phone: 702-233-7033
  • Fax:
Mailing address:
  • Phone: 805-563-3011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateNV

VIII. Authorized Official

Name: DR. EDWIN HOMANSKY
Title or Position: GENERAL PARTNER
Credential: MD
Phone: 805-563-3011