Healthcare Provider Details
I. General information
NPI: 1750607396
Provider Name (Legal Business Name): APPIAN MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2010
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7660 W CHEYENNE AVE STE 110
LAS VEGAS NV
89129-6757
US
IV. Provider business mailing address
7660 W CHEYENNE AVE STE 110
LAS VEGAS NV
89129-6757
US
V. Phone/Fax
- Phone: 702-240-5456
- Fax: 702-240-1692
- Phone: 702-240-5456
- Fax: 702-240-1692
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 4655 |
| License Number State | NV |
VIII. Authorized Official
Name:
LARRY
YEE
Title or Position: DOCTOR
Credential: MD
Phone: 702-240-5456