Healthcare Provider Details

I. General information

NPI: 1528479250
Provider Name (Legal Business Name): ADVANCED PSYCHIATRIC ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 03/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3245 S RAINBOW BLVD STE 100
LAS VEGAS NV
89146-6217
US

IV. Provider business mailing address

3245 S RAINBOW BLVD STE 100
LAS VEGAS NV
89146-6217
US

V. Phone/Fax

Practice location:
  • Phone: 702-228-4900
  • Fax: 702-228-1177
Mailing address:
  • Phone: 702-228-4900
  • Fax: 702-228-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ANURAG GUPTA
Title or Position: PRESIDENT
Credential: MD
Phone: 702-228-4900