MEDICARE: AMIR BACCHUS M.D.

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	207R00000X	Internal Medicine Physician	7888	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

General Provider Information

NPI Number	:	1619925476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIR BACCHUS M.D.

Provider Business Mailing Address
First Line	:	700 E WARM SPRINGS RD
Second Line	:	#302
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4305
Country	:	US
Telephone Number	:	702-216-3350
Fax Number	:	702-216-3356

Provider Business Practice Location Address
First Line	:	700 E WARM SPRINGS RD
Second Line	:	302
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4305
Country	:	US
Telephone Number	:	702-932-8582
Fax Number	:	702-932-8587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	11/18/2008

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Directions to “ AMIR BACCHUS M.D.” Practice Location

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