Healthcare Provider Details

I. General information

NPI: 1336175322
Provider Name (Legal Business Name): TOUSIF PASHA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 SMOKE RANCH RD SUITE 110
LAS VEGAS NV
89128-8387
US

IV. Provider business mailing address

7150 SMOKE RANCH RD SUITE 110
LAS VEGAS NV
89128-8387
US

V. Phone/Fax

Practice location:
  • Phone: 702-948-9480
  • Fax: 702-948-9488
Mailing address:
  • Phone: 702-948-9480
  • Fax: 702-948-9488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number9795
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: