Healthcare Provider Details
I. General information
NPI: 1649647181
Provider Name (Legal Business Name): IPC HEALTHCARE SERVICES OF NEVADA, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2015
Last Update Date: 09/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7391 W CHARLESTON BLVD SUITE 140
LAS VEGAS NV
89117-1501
US
IV. Provider business mailing address
7391 W CHARLESTON BLVD SUITE 140
LAS VEGAS NV
89117-1501
US
V. Phone/Fax
- Phone: 702-304-2144
- Fax: 702-304-2147
- Phone: 702-304-2144
- Fax: 702-304-2147
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADAM
SINGER
Title or Position: CEO
Credential: MD
Phone: 818-766-3502