Healthcare Provider Details

I. General information

NPI: 1578840724
Provider Name (Legal Business Name): ALBION MEDICAL GROUP OF NEVADA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3041 E FLAMINGO RD STE A
LAS VEGAS NV
89121-7447
US

IV. Provider business mailing address

12900 PARK PLAZA DR STE 150
CERRITOS CA
90703-9329
US

V. Phone/Fax

Practice location:
  • Phone: 702-436-0835
  • Fax: 702-435-6212
Mailing address:
  • Phone: 562-622-2800
  • Fax: 562-741-4479

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: TIMOTHY C. ALBION
Title or Position: OWNER
Credential: MD
Phone: 242-345-0252