Unknown Abbas

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Las Vegas, NV

NPI 1003676057 · NPPES record last updated Mar 19, 2024

Key facts

NPI
1003676057
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1701 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2312
Phone
(702) 676-3650
Fax
(702) 676-3635
NPI assigned
Mar 19, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240826000601 NV Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
4385183110

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine Past
since Mar 24, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1701 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2312

Mailing address

1701 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2312
Phone (702) 676-3650

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Student in an Organized Health Care Education/Training Program in Nevada

Sources for this page

Verify at the official NPI Registry.