Healthcare Provider Details

I. General information

NPI: 1487687539
Provider Name (Legal Business Name): LAS VEGAS SKIN AND CANCER CLINICS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4488 S PECOS RD
LAS VEGAS NV
89121-5030
US

IV. Provider business mailing address

2851 BUSINESS PARK CT
LAS VEGAS NV
89128-9005
US

V. Phone/Fax

Practice location:
  • Phone: 702-436-1001
  • Fax: 702-436-7999
Mailing address:
  • Phone: 702-360-2100
  • Fax: 702-360-3201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DENNIS SOLARI
Title or Position: CFO
Credential:
Phone: 702-436-1001