MEDICARE: PHYSICIAN TO YOU 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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DM946A	OTHER		PTAN (PROVIDER TRANSACTION ACCESS NUMBER

General Provider Information

NPI Number	:	1669791794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN TO YOU LLC

Provider Business Mailing Address
First Line	:	3571 E SUNSET RD
Second Line	:	STE 112
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-7212
Country	:	US
Telephone Number	:	702-630-0895
Fax Number	:

Provider Business Practice Location Address
First Line	:	3571 E SUNSET RD
Second Line	:	STE 112
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-7212
Country	:	US
Telephone Number	:	702-630-0895
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CATHERINE REISINGER
Credential	:
Telephone Number	:	702-630-0895

Provider Enumeration Date	:	05/28/2010
Last Update Date	:	12/15/2010

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Directions to “PHYSICIAN TO YOU LLC ” Practice Location

Language	Start Address	Practice Location

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