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General NPI Number Information
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NPI Number | 1972839231
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Entity Type | Organization
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Legal Business Name | IVAN D KARABACHEV MD CHARTERED
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Dates
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Enumeration Date | 10/21/2009
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Last Update Date | 10/21/2009
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Provider Practice Location Address
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Address Line | 3201 S MARYLAND PKWY #500
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City | LAS VEGAS
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State | NV
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Zip | 89109-2441
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Country | US
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Telephone | 702-369-3066
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Fax | 702-369-7429
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Provider Business Mailing Address
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Address Line | 3201 S MARYLAND PKWY #500
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City | LAS VEGAS
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State | NV
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Zip | 89109-2441
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Country | US
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Telephone | 702-369-3066
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Fax | 702-369-7429
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Authorized Official
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Title or Position | PRESIDENT
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Name | IVAN D KARABACHEV
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Credential | MD
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Telephone | 702-369-3066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 4229
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License Number State | NV
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