=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689011744
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEVIN P. SINAI DO LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2013
-----------------------------------------------------
Last Update Date | 05/30/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7455 W WASHINGTON AVE SUITE 200
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89128-4337
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-966-7127
-----------------------------------------------------
Fax | 702-487-7401
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7455 W WASHINGTON AVE SUITE 200
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89128-4337
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-966-7127
-----------------------------------------------------
Fax | 702-487-7401
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. KEVIN P SINAI
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 702-275-0693
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 1030
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------