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General NPI Number Information
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NPI Number | 1669180659
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Entity Type | Organization
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Legal Business Name | SIERRA SURGERY CENTER, LLC
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 5824 S DURANGO DR STE 130
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City | LAS VEGAS
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State | NV
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Zip | 89113-2314
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Country | US
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Telephone | 702-340-9994
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Fax |
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Provider Business Mailing Address
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Address Line | 870 SEVEN HILLS DR STE 101
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City | HENDERSON
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State | NV
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Zip | 89052-4378
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Country | US
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Telephone | 702-340-9994
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | OLIVIA SANTIAGO
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Credential |
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Telephone | 702-780-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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