Healthcare Provider Details

I. General information

NPI: 1265585350
Provider Name (Legal Business Name): NITA KAUL MD PC20
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11425 VALENTINO LN
LAS VEGAS NV
89138-7572
US

IV. Provider business mailing address

11425 VALENTINO LN
LAS VEGAS NV
89138-7572
US

V. Phone/Fax

Practice location:
  • Phone: 702-374-3966
  • Fax: 702-966-8002
Mailing address:
  • Phone: 702-374-3966
  • Fax: 702-966-8002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NITA KAUL
Title or Position: PRESIDENT
Credential:
Phone: 702-374-3966