Healthcare Provider Details

I. General information

NPI: 1184615098
Provider Name (Legal Business Name): MOUCHIR S. HARB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6276 S RAINBOW BLVD STE 100
LAS VEGAS NV
89118-3243
US

IV. Provider business mailing address

6276 S RAINBOW BLVD STE 100
LAS VEGAS NV
89118-3243
US

V. Phone/Fax

Practice location:
  • Phone: 702-220-5557
  • Fax: 702-220-5565
Mailing address:
  • Phone: 702-220-5557
  • Fax: 702-256-3307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number11198
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: