MEDICARE: JINLI RAN O.M.D.

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	1003	NV

General Provider Information

NPI Number	:	1376630947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JINLI RAN O.M.D.

Provider Business Mailing Address
First Line	:	7595 W. WASHINGTON AVE
Second Line	:	#A170
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4306
Country	:	US
Telephone Number	:	702-362-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	7595 W. WASHINGTON AVE
Second Line	:	#A170
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4306
Country	:	US
Telephone Number	:	702-362-1300
Fax Number	:

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/08/2007

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