MEDICARE: PACIFIC WEST MEDICAL GROUP LLC

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	2080P0205X	Pediatric Endocrinology Physician

General Provider Information

NPI Number	:	1588594055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC WEST MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	8461 FARM RD
Second Line	:	STE 120 -106
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-8306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 N TENAYA WAY STE 525
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0465
Country	:	US
Telephone Number	:	725-204-6520
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ROBERT T RIGGIO
Credential	:	M.D.
Telephone Number	:	725-204-6520

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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Directions to “PACIFIC WEST MEDICAL GROUP LLC ” Practice Location

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