MEDICARE: CHILDRENS LUNG SPECIALISTS

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	2080P0214X	Pediatric Pulmonology Physician	9572	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518916451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDRENS LUNG SPECIALISTS

Provider Business Mailing Address
First Line	:	3196 S MARYLAND PKWY STE 209
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2313
Country	:	US
Telephone Number	:	702-598-4411
Fax Number	:	702-598-1988

Provider Business Practice Location Address
First Line	:	3196 S MARYLAND PKWY STE 209
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2313
Country	:	US
Telephone Number	:	702-598-4411
Fax Number	:	702-598-1988

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	MR. CRAIG T NAKAMURA
Credential	:	MD
Telephone Number	:	702-598-4411

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	03/30/2023

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1881613891 — TANVIR BIN HOSSAIN M.D.
Practice Location Address:

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LAS VEGAS, NV
89109-2313

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1942329818 — MR. RYAN M YOSHIKAWA APN
Practice Location Address:

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LAS VEGAS, NV
89109-2313

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1912298266 — DR. ABBEY ELIZABETH BURGER DO
Practice Location Address:

3196 S MARYLAND PKWY STE 209
LAS VEGAS, NV
89109-2313

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Practice Fax:

1881099026 — BRENDA PRATT APN
Practice Location Address:

3196 S MARYLAND PKWY STE 207
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Directions to “CHILDRENS LUNG SPECIALISTS ” Practice Location

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