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NPI Code Detail

MEDICARE: MR. ATIF A TATARI D.O.

MEDICARE: MR. ATIF A TATARI D.O.
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
1207RC0000XCardiovascular Disease PhysicianDO2588NV
2207RI0011XInterventional Cardiology PhysicianDO2588NV

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 : 1366704900
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ATIF A TATARI D.O.
Provider Business Mailing Address
First Line : 700 SHADOW LN STE 240
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4158
Country : US
Telephone Number : 702-384-0022
Fax Number : 702-384-0529
Provider Business Practice Location Address
First Line : 5380 S RAINBOW BLVD STE 226
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1879
Country : US
Telephone Number : 702-384-0022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2012
Last Update Date : 09/26/2022

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