MEDICARE: DR. MEHDI ANSARINIA MD

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
1	174400000X	Specialist	9957	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033233481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEHDI ANSARINIA MD

Provider Business Mailing Address
First Line	:	8916 DIAMOND FALLS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5700
Country	:	US
Telephone Number	:	702-581-9572
Fax Number	:

Provider Business Practice Location Address
First Line	:	2835 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5307
Country	:	US
Telephone Number	:	702-951-2243
Fax Number	:	702-951-2262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	09/12/2016

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