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General NPI Number Information
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NPI Number | 1144049040
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Entity Type | Organization
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Legal Business Name | ORION WEST MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 10040 W CHEYENNE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89129-7719
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Country | US
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Telephone | 702-240-6776
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Fax | 702-240-6545
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Provider Business Mailing Address
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Address Line | 10040 W CHEYENNE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89129-7719
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Country | US
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Telephone | 702-240-6776
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Fax | 702-240-6545
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SEAN SU
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Credential | MD
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Telephone | 702-338-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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