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General NPI Number Information
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NPI Number | 1639349418
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF NEVADA SCHOOL OF MEDICINE MULTI SPECIALTY GROUP SOUTH
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 880 SEVEN HILLS DR STE 200
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City | HENDERSON
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State | NV
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Zip | 89052-4371
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Country | US
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Telephone | 702-671-5070
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Fax | 702-385-3932
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Provider Business Mailing Address
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Address Line | PO BOX 98528
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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 | 702-671-6423
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Fax | 702-671-2331
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Authorized Official
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Title or Position | PRESIDENT
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Name | 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 | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State | NV
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Taxonomy #5
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Taxonomy Code | 2084D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
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License Number |
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License Number State | NV
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Taxonomy #6
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State | NV
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Taxonomy #7
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State | NV
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