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General NPI Number Information
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NPI Number | 1518916451
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Entity Type | Organization
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Legal Business Name | CHILDRENS LUNG SPECIALISTS
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 3196 S MARYLAND PKWY STE 209
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City | LAS VEGAS
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State | NV
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Zip | 89109-2313
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Country | US
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Telephone | 702-598-4411
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Fax | 702-598-1988
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Provider Business Mailing Address
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Address Line | 3196 S MARYLAND PKWY STE 209
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City | LAS VEGAS
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State | NV
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Zip | 89109-2313
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Country | US
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Telephone | 702-598-4411
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Fax | 702-598-1988
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | MR. CRAIG T NAKAMURA
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Credential | MD
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Telephone | 702-598-4411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 9572
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License Number State | NV
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