Healthcare Provider Details

I. General information

NPI: 1811015357
Provider Name (Legal Business Name): DR BIFF MCCANN PROF CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8685 W SAHARA AVE #180
LAS VEGAS NV
89117-5880
US

IV. Provider business mailing address

10300 W CHARLESTON BLVD #13-191
LAS VEGAS NV
89135-1037
US

V. Phone/Fax

Practice location:
  • Phone: 702-360-9500
  • Fax: 702-360-9547
Mailing address:
  • Phone: 702-360-9500
  • Fax: 702-360-9547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number8640
License Number StateNV

VIII. Authorized Official

Name: DR. RAYMOND BIFF MCCANN
Title or Position: OWNER
Credential: MD
Phone: 702-360-9500