Healthcare Provider Details

I. General information

NPI: 1518196765
Provider Name (Legal Business Name): OBAND BERNSTEIN MEDICAL GROUP, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 SOUTH EASTERN AVE
LAS VEGAS NV
89119-7825
US

IV. Provider business mailing address

4440 SOUTH EASTERN AVE
LAS VEGAS NV
89119-7825
US

V. Phone/Fax

Practice location:
  • Phone: 702-487-6000
  • Fax: 702-487-6006
Mailing address:
  • Phone: 702-487-6000
  • Fax: 702-487-6006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN BERNSTEIN
Title or Position: MEDICAL DIRECTOR
Credential: M.D
Phone: 702-487-6000