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General NPI Number Information
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NPI Number | 1710220421
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Entity Type | Individual
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Provider Name | ROY CHRISTIAN GAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2013
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Last Update Date | 03/26/2023
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Provider Practice Location Address
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Address Line | 8930 W SUNSET RD STE 300
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City | LAS VEGAS
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State | NV
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Zip | 89148-5013
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Country | US
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Telephone | 702-258-7788
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Fax |
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Provider Business Mailing Address
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Address Line | 8930 W SUNSET RD STE 300
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City | LAS VEGAS
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State | NV
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Zip | 89148-5013
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Country | US
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Telephone | 702-258-7788
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD473359
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 22424
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License Number State | NV
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