Healthcare Provider Details

I. General information

NPI: 1164872024
Provider Name (Legal Business Name): RAHUL RAJIV HANDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 S DURANGO DR
LAS VEGAS NV
89113-0137
US

IV. Provider business mailing address

801 S RANCHO DR STE E6
LAS VEGAS NV
89106-3812
US

V. Phone/Fax

Practice location:
  • Phone: 702-240-6482
  • Fax: 702-240-8529
Mailing address:
  • Phone: 22-406-4827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2023019452
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number26404
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: