MEDICARE: CIMA PAIN MANAGEMENT AND REHABILITATION LLC

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1114287760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIMA PAIN MANAGEMENT AND REHABILITATION LLC

Provider Business Mailing Address
First Line	:	PO BOX 36340
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-6340
Country	:	US
Telephone Number	:	702-476-2287
Fax Number	:	702-476-2035

Provider Business Practice Location Address
First Line	:	1321 S RAINBOW BLVD STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-9047
Country	:	US
Telephone Number	:	702-476-2287
Fax Number	:	702-476-2035

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. ROBERT JOSEPH WEBB
Credential	:	PA-C
Telephone Number	:	702-476-2287

Provider Enumeration Date	:	05/16/2012
Last Update Date	:	05/16/2012

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