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NPI Code Detail

MEDICARE: QRD HEALTH LLC

MEDICARE: QRD HEALTH 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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number : 1124590203
Entity Type Code : Organization
Provider Name (Legal Business Name) : QRD HEALTH LLC
Provider Business Mailing Address
First Line : 9315 W SUNSET RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5012
Country : US
Telephone Number : 702-638-7705
Fax Number : 702-638-7706
Provider Business Practice Location Address
First Line : 9315 W SUNSET RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5012
Country : US
Telephone Number : 702-638-7705
Fax Number : 702-638-7706
Authorized Official
Title or Position : CEO
Name : ROLAND JAYSON F PUA
Credential : M.D.
Telephone Number : 702-638-7705
Provider Enumeration Date : 12/29/2018
Last Update Date : 12/29/2018

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Directions to “QRD HEALTH LLC ” Practice Location

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