Healthcare Provider Details

I. General information

NPI: 1467561142
Provider Name (Legal Business Name): SALDI,LTD,BDA, COVENANT MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 E CHARLESTON BLVD
LAS VEGAS NV
89104-5525
US

IV. Provider business mailing address

4550 E CHARLESTON BLVD
LAS VEGAS NV
89104-5525
US

V. Phone/Fax

Practice location:
  • Phone: 702-938-6972
  • Fax: 702-938-6962
Mailing address:
  • Phone: 702-938-6972
  • Fax: 702-938-6962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERASTO R SALDI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 702-459-5500