Healthcare Provider Details

I. General information

NPI: 1952660656
Provider Name (Legal Business Name): MELVIN MCBEAN ORTHOPEDIC PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2012
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9321 W SUNSET RD
LAS VEGAS NV
89148-4845
US

IV. Provider business mailing address

9321 W SUNSET RD
LAS VEGAS NV
89148-4845
US

V. Phone/Fax

Practice location:
  • Phone: 702-645-7800
  • Fax: 702-650-0865
Mailing address:
  • Phone: 702-645-7800
  • Fax: 702-650-0865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2324
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: