=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164414215
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KOSTA M. ARGER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2005
-----------------------------------------------------
Last Update Date | 10/06/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2385 E PRATER WAY STE 302
-----------------------------------------------------
City | SPARKS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89434-9638
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-356-4514
-----------------------------------------------------
Fax | 775-356-4991
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2345 E PRATER WAY STE 207
-----------------------------------------------------
City | SPARKS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89434-9634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-356-4514
-----------------------------------------------------
Fax | 775-356-4991
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | G48317
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 4093
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------