Healthcare Provider Details

I. General information

NPI: 1891906780
Provider Name (Legal Business Name): SAMUEL AUERBACH MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 MOHAWK ST
LAS VEGAS NV
89107-3711
US

IV. Provider business mailing address

913 MOHAWK ST
LAS VEGAS NV
89107-3711
US

V. Phone/Fax

Practice location:
  • Phone: 805-953-5848
  • Fax: 718-273-4996
Mailing address:
  • Phone: 805-953-5848
  • Fax: 718-273-4996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL AUERBACH
Title or Position: PRESIDENT
Credential: MD
Phone: 805-953-5848