Healthcare Provider Details

I. General information

NPI: 1255095840
Provider Name (Legal Business Name): CONCIERGE HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2021
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10845 GRIFFITH PEAK DR # 2
LAS VEGAS NV
89135-1553
US

IV. Provider business mailing address

10845 GRIFFITH PEAK DR # 2
LAS VEGAS NV
89135-1553
US

V. Phone/Fax

Practice location:
  • Phone: 323-638-9578
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TROY SIMON
Title or Position: CEO
Credential:
Phone: 323-638-9578