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General NPI Number Information
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NPI Number | 1750561833
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Entity Type | Organization
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Legal Business Name | PASSION MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 4240 SIMMONS ST
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-0766
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Country | US
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Telephone | 702-798-1233
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Fax | 702-531-1233
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Provider Business Mailing Address
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Address Line | PO BOX 371708
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City | LAS VEGAS
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State | NV
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Zip | 89137-1708
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Country | US
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Telephone | 702-798-1233
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Fax | 702-531-1233
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Authorized Official
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Title or Position | MEMBER
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Name | PETER K ASAFO-ADJEI
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Credential | M.D.
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Telephone | 702-868-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12241
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License Number State | NV
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