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General NPI Number Information
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NPI Number | 1922733559
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Entity Type | Organization
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Legal Business Name | OPTUM MEDICAL GROUP RHODES P C
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 2300 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-2149
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Country | US
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Telephone | 702-724-8787
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 702-579-3203
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR
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Name | EMILY CASTILLO
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Credential |
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Telephone | 702-480-2550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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