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General NPI Number Information
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NPI Number | 1871094862
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Entity Type | Organization
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Legal Business Name | CLARK COUNTY MEDICAL GROUP LLC
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Dates
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Enumeration Date | 02/24/2018
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 3650 S EASTERN AVE STE 330
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City | LAS VEGAS
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State | NV
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Zip | 89169-3345
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Country | US
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Telephone | 702-524-9599
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Fax |
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Provider Business Mailing Address
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Address Line | 3650 S EASTERN AVE STE 330
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City | LAS VEGAS
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State | NV
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Zip | 89169-3345
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Country | US
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Telephone | 702-524-9599
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ELSIE C DALOPE
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Credential |
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Telephone | 725-204-5221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | NV
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