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General NPI Number Information
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NPI Number | 1811717168
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Entity Type | Organization
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Legal Business Name | CULTIVATING COMMUNITIES TOGETHER HEALTH CENTERS
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 2435 FIRE MESA ST STE 130
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City | LAS VEGAS
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State | NV
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Zip | 89128-9009
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Country | US
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Telephone | 843-814-5177
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Fax |
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Provider Business Mailing Address
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Address Line | 8379 W SUNSET RD STE 210
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City | LAS VEGAS
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State | NV
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Zip | 89113-2243
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Country | US
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Telephone | 843-814-5177
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RAJ SONANI
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Credential |
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Telephone | 678-989-8942
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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 |
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License Number State |
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