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NPI Code Detail

MEDICARE: STEVEN JIMENEZ M.D. INC.

MEDICARE: STEVEN JIMENEZ M.D. INC.
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
1207Q00000XFamily Medicine Physician
2261Q00000XClinic/Center8183NV

Other Identifiers

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

General Provider Information

NPI Number : 1073813945
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEVEN JIMENEZ M.D. INC.
Provider Business Mailing Address
First Line : 4974 S RAINBOW BLVD
Second Line : SUITE 120
City : LAS VEGAS
State : NV
Zip : 89118-1400
Country : US
Telephone Number : 702-367-0323
Fax Number : 702-367-4431
Provider Business Practice Location Address
First Line : 4974 S RAINBOW BLVD
Second Line : SUITE 120
City : LAS VEGAS
State : NV
Zip : 89118-1400
Country : US
Telephone Number : 702-367-0323
Fax Number : 702-367-4431
Authorized Official
Title or Position : OFFICE MANAGER, TREASURER,SECRETARY
Name : MRS. HELENA RENEE JIMENEZ
Credential :
Telephone Number : 702-367-0323
Provider Enumeration Date : 10/26/2010
Last Update Date : 06/09/2021

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Directions to “STEVEN JIMENEZ M.D. INC. ” Practice Location

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