Healthcare Provider Details

I. General information

NPI: 1790272524
Provider Name (Legal Business Name): LAS VEGAS SLEEP CENTER SHAMIYA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S CIMARRON RD, SUITE 130
LAS VEGAS NV
89117
US

IV. Provider business mailing address

2400 S CIMARRON RD STE 130
LAS VEGAS NV
89117-7902
US

V. Phone/Fax

Practice location:
  • Phone: 702-478-8819
  • Fax: 702-478-7324
Mailing address:
  • Phone: 702-478-8819
  • Fax: 702-478-7324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberNV20181237031
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED SHAMIYA
Title or Position: PRESIDENT
Credential: MD
Phone: 614-629-7076