Healthcare Provider Details
I. General information
NPI: 1356237051
Provider Name (Legal Business Name): A PLUS MOBILE PRIMARY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4472 S EASTERN AVE
LAS VEGAS NV
89119-7825
US
IV. Provider business mailing address
4472 S EASTERN AVE
LAS VEGAS NV
89119-7825
US
V. Phone/Fax
- Phone: 702-202-1050
- Fax:
- Phone: 702-202-1050
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3104A0630X |
| Taxonomy | Assisted Living Facility (Behavioral Disturbances) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LC0200X |
| Taxonomy | Critical Care Medicine Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHKAN
HASHEMI SABOUR
Title or Position: OPERATIONS
Credential: PA
Phone: 702-202-1050