=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164647244
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOUCHIR S HARB MD LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2007
-----------------------------------------------------
Last Update Date | 05/05/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6276 S RAINBOW BLVD SUITE 100
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89118-3242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-220-5557
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6276 S RAINBOW BLVD SUITE 100
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89118-3242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-220-5557
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | MOUCHIR S HARB
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 702-220-5557
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084S0012X
-----------------------------------------------------
Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------