| Spring Mountain Medical Center Pllc | |
|
4276 Spring Mountain Rd Unit 211 Las Vegas NV 89102-8781 | |
| (702) 802-8567 | |
| Not Available |
| Full Name | Spring Mountain Medical Center Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4276 Spring Mountain Rd Unit 211, Las Vegas, Nevada |
| Authorized Official Name and Position | Rafael Okamoto (OWNER) |
| Authorized Official Contact | 7143767853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spring Mountain Medical Center Pllc 4276 Spring Mountain Rd Unit 211 Las Vegas NV 89102-8781 Ph: () - | Spring Mountain Medical Center Pllc 4276 Spring Mountain Rd Unit 211 Las Vegas NV 89102-8781 Ph: (702) 802-8567 |
| NPI Number | 1639791791 |
|---|---|
| Provider Enumeration Date | 05/12/2020 |
| Last Update Date | 05/12/2020 |
| Medicare PECOS PAC ID | 2365811312 |
|---|---|
| Medicare Enrollment ID | O20221213002806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639791791 | NPI | - | NPPES |
| 1235281874 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rafael Okamoto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235281874 PECOS PAC ID: 0345344123 Enrollment ID: I20070404000176 |
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