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General NPI Number Information
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NPI Number | 1568560555
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 8757 CARLITAS JOY CT
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City | LAS VEGAS
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State | NV
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Zip | 89117-3540
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Country | US
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Telephone | 702-250-8076
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Fax | 702-586-4567
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Provider Business Mailing Address
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Address Line | 8757 CARLITAS JOY CT
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City | LAS VEGAS
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State | NV
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Zip | 89117-3540
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Country | US
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Telephone | 702-250-8076
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MALEK M NAZEMI
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Credential | M.D.
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Telephone | 702-250-8076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 10172
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License Number State | NV
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