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General NPI Number Information
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NPI Number | 1710528047
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Entity Type | Organization
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Legal Business Name | LASER FOOT SURGERY CENTERS, LLC
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 06/06/2020
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Provider Practice Location Address
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Address Line | 880 SEVEN HILLS DR STE 150
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City | HENDERSON
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State | NV
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Zip | 89052-4380
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Country | US
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Telephone | 833-693-3381
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Fax | 702-852-0429
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Provider Business Mailing Address
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Address Line | 9107 WILSHIRE BLVD STE 450
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5535
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Country | US
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Telephone | 323-440-4299
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Fax |
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Authorized Official
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Title or Position | BILLING/CREDENTIALING MANAGER
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Name | KRYSTAL BENSON
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Credential |
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Telephone | 702-600-7977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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