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General NPI Number Information
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NPI Number | 1336660026
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Entity Type | Organization
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Legal Business Name | CLIFFORD JOEL MOLIN MD LTD
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 07/03/2017
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Provider Practice Location Address
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Address Line | 2481 PROFESSIONAL CT
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City | LAS VEGAS
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State | NV
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Zip | 89128-0825
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Country | US
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Telephone | 702-242-1562
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Fax | 702-240-4962
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Provider Business Mailing Address
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Address Line | 2481 PROFESSIONAL CT
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City | LAS VEGAS
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State | NV
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Zip | 89128-0825
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE DIRECTOR
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Name | FRANCES MALINIS
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Credential |
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Telephone | 702-410-7825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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