Healthcare Provider Details

I. General information

NPI: 1750846614
Provider Name (Legal Business Name): TALI ARIK MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3370 S NEVADA HIGHWAY 160 STE 10
PAHRUMP NV
89048-5373
US

IV. Provider business mailing address

3370 S NEVADA HIGHWAY 160 STE 10
PAHRUMP NV
89048-5373
US

V. Phone/Fax

Practice location:
  • Phone: 775-467-3711
  • Fax: 775-467-3712
Mailing address:
  • Phone: 775-467-3711
  • Fax: 775-467-3712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TALI ARIK
Title or Position: OWNER
Credential: MD
Phone: 775-467-3711