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NPI Code Detail

MEDICARE: REIICHI IIZUKA, M.D. CHTD.

MEDICARE: REIICHI IIZUKA, M.D. CHTD.
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
1207L00000XAnesthesiology Physician2426NV

General Provider Information

NPI Number : 1619165289
Entity Type Code : Organization
Provider Name (Legal Business Name) : REIICHI IIZUKA, M.D. CHTD.
Provider Business Mailing Address
First Line : 3010 W CHARLESTON BLVD
Second Line : STE 150
City : LAS VEGAS
State : NV
Zip : 89102-1966
Country : US
Telephone Number : 702-878-0070
Fax Number : 702-818-1930
Provider Business Practice Location Address
First Line : 3010 W CHARLESTON BLVD
Second Line : STE 150
City : LAS VEGAS
State : NV
Zip : 89102-1966
Country : US
Telephone Number : 702-878-0070
Fax Number : 702-818-1930
Authorized Official
Title or Position : MD
Name : DR. REIICHI IIZUKA
Credential :
Telephone Number : 702-878-0070
Provider Enumeration Date : 10/09/2007
Last Update Date : 10/09/2007

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Directions to “REIICHI IIZUKA, M.D. CHTD. ” Practice Location

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