MEDICARE: PAUL TOMASIC

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	11487	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
4	VWCHKL	OTHER	NV	NORIDIAN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750354239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL TOMASIC

Provider Business Mailing Address
First Line	:	9260 W SUNSET RD
Second Line	:	STE. 200
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4858
Country	:	US
Telephone Number	:	702-255-3547
Fax Number	:	702-921-2419

Provider Business Practice Location Address
First Line	:	9260 W SUNSET RD STE 207
Second Line	:	STE. 207
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4903
Country	:	US
Telephone Number	:	702-304-5756
Fax Number	:	702-906-0933

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	02/01/2017

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Directions to “ PAUL TOMASIC ” Practice Location

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