MEDICARE: DR. POOJA G MODY D.O

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	208600000X	Surgery Physician	DO3284	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

General Provider Information

NPI Number	:	1962762997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. POOJA G MODY D.O

Provider Business Mailing Address
First Line	:	1800 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2386
Country	:	US
Telephone Number	:	702-383-2799
Fax Number	:	702-383-2477

Provider Business Practice Location Address
First Line	:	1524 PINTO LN FL 2
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4195
Country	:	US
Telephone Number	:	702-383-3707
Fax Number	:	702-383-1982

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

Provider Enumeration Date	:	05/24/2012
Last Update Date	:	05/13/2026

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Directions to “ DR. POOJA G MODY D.O” Practice Location

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