Healthcare Provider Details

I. General information

NPI: 1770635153
Provider Name (Legal Business Name): V RANGA MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E DESERT INN RD STE 301
LAS VEGAS NV
89169
US

IV. Provider business mailing address

2645 PARIS AMOUR ST
HENDERSON NV
89044-0333
US

V. Phone/Fax

Practice location:
  • Phone: 702-649-8009
  • Fax: 702-649-8049
Mailing address:
  • Phone: 702-649-8009
  • Fax: 702-649-8049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9296
License Number StateNV

VIII. Authorized Official

Name: VISHWESHWAR RANGA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 702-649-8009