| Las Vegas Mobile Medical Group Pc | |
|
9017 S Pecos Rd Ste 4540 Henderson NV 89074-6604 | |
| (626) 347-8548 | |
| Not Available |
| Full Name | Las Vegas Mobile Medical Group Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 9017 S Pecos Rd Ste 4540, Henderson, Nevada |
| Authorized Official Name and Position | Shylee Tiamson (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6263478548 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Las Vegas Mobile Medical Group Pc 9017 S Pecos Rd Ste 4540 Henderson NV 89074-6604 Ph: () - | Las Vegas Mobile Medical Group Pc 9017 S Pecos Rd Ste 4540 Henderson NV 89074-6604 Ph: (626) 347-8548 |
| NPI Number | 1144090770 |
|---|---|
| Provider Enumeration Date | 01/04/2024 |
| Last Update Date | 01/04/2024 |
| Medicare PECOS PAC ID | 4385080969 |
|---|---|
| Medicare Enrollment ID | O20240306002781 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144090770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Carlota Barde Cinco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891336301 PECOS PAC ID: 2264669290 Enrollment ID: I20210108001965 |
| Provider Name | Kesha Saucier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407254881 PECOS PAC ID: 2769774439 Enrollment ID: I20240409003030 |
| Provider Name | Christina Quijano Pangan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609614650 PECOS PAC ID: 9537609144 Enrollment ID: I20240910003515 |
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