Healthcare Provider Details
I. General information
NPI: 1457384448
Provider Name (Legal Business Name): TOTTORI ALLERGY & ASTHMA ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2006
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4000 E CHARLESTON BLVD STE 100
LAS VEGAS NV
89104-6683
US
IV. Provider business mailing address
4000 E CHARLESTON BLVD STE 100
LAS VEGAS NV
89104-6683
US
V. Phone/Fax
- Phone: 702-432-8250
- Fax: 702-734-6677
- Phone: 702-432-8250
- Fax: 702-734-6677
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 6370 |
| License Number State | NV |
VIII. Authorized Official
Name: DR.
DAVID
H
TOTTORI
Title or Position: OWNER
Credential: M.D.
Phone: 702-432-8250