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NPI Code Detail

MEDICARE: DR. JIMMY DIEP M.D.

MEDICARE: DR. JIMMY DIEP M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0011XInterventional Cardiology Physician13444NV
2207RC0000XCardiovascular Disease Physician13444NV
3207R00000XInternal Medicine Physician13444NV
4207R00000XInternal Medicine PhysicianA111256CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113444OTHERNVNV MEDICAL LICENSE
2LL1738OTHERNVMEDICAL LICENSE
3CS18484OTHERNVNV PHARMACY

General Provider Information

NPI Number : 1023132511
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JIMMY DIEP M.D.
Provider Business Mailing Address
First Line : 700 E SILVERADO RANCH BLVD STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-7518
Country : US
Telephone Number : 702-240-6482
Fax Number : 702-804-0957
Provider Business Practice Location Address
First Line : 4275 BURNHAM AVE STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5400
Country : US
Telephone Number : 702-240-6482
Fax Number : 702-240-8529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 03/07/2023

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Directions to “ DR. JIMMY DIEP M.D.” Practice Location

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