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General NPI Number Information
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NPI Number | 1568595114
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF NV SCHOOL OF MEDICINE MULTI SPECIALTY GROUP PRACTICE SO.
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 3150 N TENAYA WAY STE 140
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City | LAS VEGAS
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State | NV
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Zip | 89128-0443
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Country | US
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Telephone | 702-671-6480
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Fax | 702-671-6481
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Provider Business Mailing Address
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Address Line | PO BOX 98528 DEPT. 401
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City | LAS VEGAS
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State | NV
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Zip | 89193-8528
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Country | US
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Telephone | 702-671-2395
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Fax | 702-382-5388
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM A. ZAMBONI
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Credential | MD
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Telephone | 702-671-2278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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