| Brighton Family Medicine | |
|
1720 W Horizon Ridge Pkwy Ste 140 Henderson NV 89012-4896 | |
| (702) 566-5445 | |
| (702) 566-5035 |
| Full Name | Brighton Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1720 W Horizon Ridge Pkwy Ste 140, Henderson, Nevada |
| Authorized Official Name and Position | Sungwook S Kim (PRESIDENT) |
| Authorized Official Contact | 7025665445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brighton Family Medicine 1450 W Horizon Ridge Pkwy Ste B305 # 570 Henderson NV 89012-4480 Ph: (702) 566-5445 | Brighton Family Medicine 1720 W Horizon Ridge Pkwy Ste 140 Henderson NV 89012-4896 Ph: (702) 566-5445 |
| NPI Number | 1134323561 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 05/02/2023 |
| Certification Date | 05/02/2023 |
| Medicare PECOS PAC ID | 2567556947 |
|---|---|
| Medicare Enrollment ID | O20070915000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134323561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 363A00000X | Physician Assistant | () | Secondary |
| 363LF0000X | Nurse Practitioner - Family | () | Secondary |
| Provider Name | Sungwook S Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871798900 PECOS PAC ID: 1850485152 Enrollment ID: I20070918000177 |
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