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NPI Code Detail

MEDICARE: VEGAS MEDICAL CENTER PLLC

MEDICARE: VEGAS MEDICAL CENTER PLLC
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
1111N00000XChiropractorB00862NV
2207LP2900XPain Medicine (Anesthesiology) Physician7683NV

General Provider Information

NPI Number : 1508219833
Entity Type Code : Organization
Provider Name (Legal Business Name) : VEGAS MEDICAL CENTER PLLC
Provider Business Mailing Address
First Line : 1701 W CHARLESTON BLVD STE 600
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2343
Country : US
Telephone Number : 702-763-4585
Fax Number : 702-921-9264
Provider Business Practice Location Address
First Line : 1701 W CHARLESTON BLVD STE 600
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2343
Country : US
Telephone Number : 702-763-4585
Fax Number : 702-921-9264
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : QUAN HADUONG
Credential : MD
Telephone Number : 702-763-4585
Provider Enumeration Date : 07/21/2016
Last Update Date : 03/07/2019

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Directions to “VEGAS MEDICAL CENTER PLLC ” Practice Location

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