Healthcare Provider Details

I. General information

NPI: 1952436115
Provider Name (Legal Business Name): PULMONARY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WELLNESS WAY
LAS VEGAS NV
89106-4113
US

IV. Provider business mailing address

PO BOX 81345
LAS VEGAS NV
89180-1345
US

V. Phone/Fax

Practice location:
  • Phone: 702-384-5101
  • Fax: 702-387-0104
Mailing address:
  • Phone: 702-384-5101
  • Fax: 702-382-5675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SONYA KOHL
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 702-384-5101