Healthcare Provider Details

I. General information

NPI: 1346243367
Provider Name (Legal Business Name): NAVID KAZEMI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 N TENAYA WAY STE 460
LAS VEGAS NV
89128-0463
US

IV. Provider business mailing address

3201 S MARYLAND PKWY STE 400
LAS VEGAS NV
89109-2426
US

V. Phone/Fax

Practice location:
  • Phone: 702-233-1000
  • Fax: 702-233-1001
Mailing address:
  • Phone: 702-796-7150
  • Fax: 702-796-9071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number11063
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: