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General NPI Number Information
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NPI Number | 1730366659
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Entity Type | Organization
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Legal Business Name | AFSHIN Y DOUST MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 3100 N TENAYA WAY
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City | LAS VEGAS
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State | NV
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Zip | 89128-0436
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Provider Business Mailing Address
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Address Line | PO BOX 370969
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City | LAS VEGAS
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State | NV
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Zip | 89137-0969
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Authorized Official
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Title or Position | OWNER
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Name | AFSHIN Y DOUST
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Credential | MD
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Telephone | 702-204-5596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11054
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License Number State | NV
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