Healthcare Provider Details

I. General information

NPI: 1538178991
Provider Name (Legal Business Name): HAMIDREZA SANATINIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9280 W SUNSET RD STE 100
LAS VEGAS NV
89148-4861
US

IV. Provider business mailing address

400 N STEPHANIE ST STE 300
HENDERSON NV
89014-6692
US

V. Phone/Fax

Practice location:
  • Phone: 702-952-1251
  • Fax: 702-952-1242
Mailing address:
  • Phone: 702-952-3350
  • Fax: 702-952-3365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number9960
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: