MEDICARE: ALPINE HOSPITALIST GROUP LLLP

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	207Q00000X	Family Medicine Physician	11478	NV

General Provider Information

NPI Number	:	1457783987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPINE HOSPITALIST GROUP LLLP

Provider Business Mailing Address
First Line	:	3022 S DURANGO DR
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-4439
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3061 S MARYLAND PKWY STE 104
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-6226
Country	:	US
Telephone Number	:	24-385-5557
Fax Number	:	702-438-6666

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	ALEXANDER AKHAVAN
Credential	:	MD
Telephone Number	:	702-561-5536

Provider Enumeration Date	:	08/07/2013
Last Update Date	:	10/13/2022

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