Healthcare Provider Details
I. General information
NPI: 1922325448
Provider Name (Legal Business Name): GEORGE J PAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/23/2010
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2851 N TENAYA WAY STE 104
LAS VEGAS NV
89128-0453
US
IV. Provider business mailing address
2851 N TENAYA WAY STE 104
LAS VEGAS NV
89128-0453
US
V. Phone/Fax
- Phone: 702-702-2002
- Fax:
- Phone: 702-702-2002
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207WX0107X |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| License Number | 22270 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: