=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205088978
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAIG MEDICAL CLINICS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2008
-----------------------------------------------------
Last Update Date | 03/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9480 S EASTERN AVE SUITE 273
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89123-8024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-686-4473
-----------------------------------------------------
Fax | 702-365-9088
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 231866
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89105-1866
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-686-4473
-----------------------------------------------------
Fax | 702-365-9088
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. KHALIQ R BAIG
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 702-686-4473
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 6779
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------