| Craniom Llc | |
|
575 Los Altos Cir Mesquite NV 89027-2523 | |
| (701) 388-5390 | |
| Not Available |
| Full Name | Craniom Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 575 Los Altos Cir, Mesquite, Nevada |
| Authorized Official Name and Position | James Tritchler (MANAGER) |
| Authorized Official Contact | 7013885390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Craniom Llc 575 Los Altos Cir Mesquite NV 89027-2523 Ph: (701) 388-5390 | Craniom Llc 575 Los Altos Cir Mesquite NV 89027-2523 Ph: (701) 388-5390 |
| NPI Number | 1396256293 |
|---|---|
| Provider Enumeration Date | 10/18/2017 |
| Last Update Date | 09/23/2021 |
| Certification Date | 09/23/2021 |
| Medicare PECOS PAC ID | 3971901810 |
|---|---|
| Medicare Enrollment ID | O20211007001721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396256293 | NPI | - | NPPES |
| Provider Name | Kevin Mochizuki |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1871679787 PECOS PAC ID: 0042363053 Enrollment ID: I20211011001233 |
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