| Canyon Gate Medical Group | |
|
330 S Lola Ln Suite# 200 Pahrump NV 89048-0884 | |
| (954) 656-8855 | |
| Not Available |
| Full Name | Canyon Gate Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 330 S Lola Ln, Pahrump, Nevada |
| Authorized Official Name and Position | Veronica Colon (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 9546568855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Gate Medical Group 2929 N University Dr Suite# 110 Coral Springs FL 33065-5081 Ph: (775) 751-0695 | Canyon Gate Medical Group 330 S Lola Ln Suite# 200 Pahrump NV 89048-0884 Ph: (954) 656-8855 |
| NPI Number | 1134421712 |
|---|---|
| Provider Enumeration Date | 12/02/2010 |
| Last Update Date | 12/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134421712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 936 (Nevada) | Primary |
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