Healthcare Provider Details

I. General information

NPI: 1851153027
Provider Name (Legal Business Name): ASPIRE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6870 S RAINBOW BLVD STE 106-107
LAS VEGAS NV
89118-2106
US

IV. Provider business mailing address

6870 S RAINBOW BLVD STE 107
LAS VEGAS NV
89118-2107
US

V. Phone/Fax

Practice location:
  • Phone: 702-750-0659
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MAI VI HA HOANG
Title or Position: CHIEF MEDICAL DIRECTOR
Credential: MD
Phone: 702-750-0659