NPI | 1932919750 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHNATHAN R TAITANO Practice Owner 702-509-6028 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
261QU0200X Clinic/Center, Urgent Care | |
Enumeration Date | 2025-01-13 |
Last Update Date | 2025-02-08 |