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General NPI Number Information
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NPI Number | 1033436621
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF NV SCHOOL MULTISPECIALTY GROUP PRACTICE SOUTH INC
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 3006 S MARYLAND PKWY 320
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City | LAS VEGAS
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State | NV
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Zip | 89109-2218
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Country | US
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Telephone | 702-992-6868
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Fax | 702-992-6830
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Provider Business Mailing Address
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Address Line | 3006 S MARYLAND PKWY 320
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City | LAS VEGAS
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State | NV
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Zip | 89109-2218
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Country | US
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Telephone | 702-992-6868
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Fax | 702-992-6830
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM A. ZAMBONI
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Credential | MD
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Telephone | 702-671-2278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 10664
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 3166
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 10031
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 10748
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License Number State | NV
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Taxonomy #5
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 5408
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License Number State | NV
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Taxonomy #6
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 9696
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License Number State | NV
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Taxonomy #7
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 6968
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License Number State | NV
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Taxonomy #8
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 13193
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License Number State | NV
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