Active NPI
Malwinder Sidhu MD PC
- Gastroenterology Physician
- Las Vegas, NV
National Provider Identifier
1407903578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 11493
- Legal business name
- MALWINDER SIDHU MD PC
- Practice address
- 7455 W Washington Ave
Ste 275
Las Vegas, NV 89128-4337 - Phone
- (702) 228-4006
- Fax
- (702) 228-0066
- NPI assigned
- Jan 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Malwinder Sidhu, MD
- Title
- Owner
- Phone
- (702) 798-3008
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 11493 | NV | Primary |
Addresses
Primary practice location
7455 W Washington Ave
Ste 275
Las Vegas, NV 89128-4337
Mailing address
PO Box 36396
Las Vegas, NV 89133-6396
Phone (702) 228-4006
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720189095 | Other | NV | IND NPI |
| V104162 | Other | NV | GROUP PTAN |
| 11493 | Other | NV | MEDICAL LICENSE |
| V104161 | Other | NV | IND PTAN |
| 1720189095 | Medicaid | NV |
National Provider Directory
National Provider DirectoryLocations
5785 S Fort Apache Rd
#B100
Las Vegas, NV 89148
Phone (702) 228-4006
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1279152000000",
"number": "1407903578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 36396",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891336396",
"telephone_number": "702-228-4006",
"fax_number": "702-228-0066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7455 W WASHINGTON AVE",
"address_2": "STE 275",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891284337",
"telephone_number": "702-228-4006",
"fax_number": "702-228-0066"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MALWINDER SIDHU MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-04",
"last_updated": "2010-07-15",
"status": "A",
"authorized_official_last_name": "SIDHU",
"authorized_official_first_name": "MALWINDER",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "702-798-3008",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "NV",
"license": "11493",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IND NPI",
"identifier": "1720189095",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PTAN",
"identifier": "V104162",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "11493",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IND PTAN",
"identifier": "V104161",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1720189095",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.