Medella Family Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MEDELLA FAMILY CLINIC LLC

Doing business as

Medella On The Go

Practice address

4760 S Pecos Rd Ste 103-4
Las Vegas, NV 89121-6038

Phone

(725) 247-6858

NPI assigned

Nov 10, 2022

Organization subpart

No

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

Authorized official

Name

Alexander Rasavong

Title

Administrator

Phone

(725) 247-6858

Specialties & licenses 1

Addresses

Other names 1

• Medella On The Go Doing business as

Locations

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1790493401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 S PECOS RD STE 103-4",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891216038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 S PECOS RD STE 103-4",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891216038",
            "telephone_number": "725-247-6858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3920 E Patrick Ln Ste 8",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891203927",
            "country_code": "US",
            "telephone_number": "702-533-5669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDELLA FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-10",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "RASAVONG",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "725-247-6858"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medella On The Go",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medella On The Go",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ariadna Medecki
• Carissa R Medeiros
• Michael Anthony Medeiros
• Alexis Marie Medel
• Medelite Capital, LLC (OrthoCorp)
• Tamara Medellin
• Sabrina Christine Medendorp
• Yurema Medero Cueva
• Gisselle Medero
• Rudy Medero

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.