| NPI | 1174564009 |
|---|---|
| Doing Business As | ORTHOPEDIC & SPORTS MEDICINE INSTITUTE OF LAS VEGAS |
| Entity Type | Organization |
| Authorized Contact | RANDA AMIN BASCHARON Owner Pres Sec Etc 702-596-0036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV 1103) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A8358) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NV 1103) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA 20A8358) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2010-02-18 |