NPI 1487066072 · live from the CMS NPI Registry
A Third Hand
Physician Assistant, Surgical in Las Vegas, NV. National Provider Identifier 1487066072, active.
NPI record
| NPI | 1487066072 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Surgical 363AS0400X |
| Practice location | 9806 Red Deer St, Las Vegas, NV 89143 |
| Practice phone | 702-985-8297 |
| Enumerated | May 30, 2014 |
| Last updated | June 22, 2018 |
| Authorized official | Ronald Moon, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist/Technologist, Other, Surgical Assistant | 246ZC0007X | 132674 (NV) |
| Physician Assistant, Surgical primary | 363AS0400X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.