Physicians Health Net, Inc.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

9244 Issued in NV

Legal business name

PHYSICIANS HEALTH NET, INC.

Doing business as

CENTRO MEDICO FAMILIAR

Practice address

865 N Eastern Ave
Las Vegas, NV 89101-2312

Phone

(702) 399-2345

NPI assigned

Oct 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Rafael Mirchou, M.D.

Title

Cfo

Phone

(702) 399-2345

Specialties & licenses 1

Addresses

Other names 1

• CENTRO MEDICO FAMILIAR Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teresita D Rand, PA-C

  • Medical Physician Assistant
  • Nellis Afb, NV
  • NPI 1477635464
  NPD (past)
• Ricardo J Velazquez, MD

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1831278928
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578647871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 N EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891012312",
            "telephone_number": "702-399-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 N EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891012312",
            "telephone_number": "702-399-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS HEALTH NET, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIRCHOU",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "702-399-2345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NV",
            "license": "9244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRO MEDICO FAMILIAR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Service Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Health Service Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.