Theodore Potruch, MD | |
2123 Civic Center Dr, North Las Vegas, NV 89030-6327 | |
(702) 333-1110 | |
(702) 685-0744 |
Full Name | Theodore Potruch |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 2123 Civic Center Dr, North Las Vegas, Nevada |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649225293 | NPI | - | NPPES |
V50306 | Other | NV | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 3310 (Nevada) | Primary |
Entity Name | Angeles Medical Centers Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609327931 PECOS PAC ID: 9830472372 Enrollment ID: O20170208001056 |
Mailing Address | Practice Location Address |
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Theodore Potruch, MD 2123 Civic Center Dr, North Las Vegas, NV 89030-6327 Ph: (702) 333-1110 | Theodore Potruch, MD 2123 Civic Center Dr, North Las Vegas, NV 89030-6327 Ph: (702) 333-1110 |
Dr. Jaclyn L. Munn, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 6900 Pecos Rd, Surgical Department Mail Code 112, North Las Vegas, NV 89086 Phone: 702-791-9000 | |
Laurier Joseph Tremblay Jr., M.D. Surgery Medicare: Medicare Enrolled Practice Location: 6900 Pecos Rd, Va Hospital, Department Of Surgery, North Las Vegas, NV 89086 Phone: 702-791-9000 | |
Dr. Vicente D. Narciso, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 7368 Night Heron Way, Ward 3c, North Las Vegas, NV 89084 Phone: 702-638-0099 Fax: 702-638-0099 | |
Luis Panuncialman, M.D.,F.A.C.S. Surgery Medicare: Medicare Enrolled Practice Location: 6900 Pecos Rd, North Las Vegas, NV 89086 Phone: 702-791-9000 Fax: 702-791-9110 | |
Dr. Issa Seyed Mirmehdi, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 6900 N Pecos Rd Ste 3b226, North Las Vegas, NV 89086 Phone: 702-791-9000 |