MEDICARE: DR. ALEXANDER LEON PORTNEY 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	207R00000X	Internal Medicine Physician	9534	NV

General Provider Information

NPI Number	:	1437225927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER LEON PORTNEY M.D.

Provider Business Mailing Address
First Line	:	810 S DURANGO DR
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-2423
Country	:	US
Telephone Number	:	702-240-0874
Fax Number	:	702-240-3627

Provider Business Practice Location Address
First Line	:	810 S DURANGO DR
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-2423
Country	:	US
Telephone Number	:	702-240-0874
Fax Number	:	702-240-3627

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

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	12/05/2010

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