1982894150 NPI number — LAWSON CHARLES RICHTER MD LTD

Table of content: (NPI 1982894150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982894150 NPI number — LAWSON CHARLES RICHTER MD LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAWSON CHARLES RICHTER MD LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMPASSIONATE CARE FOR WOMEN
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982894150
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
840 S RANCHO DR STE 4-363
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89106-3837
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-256-3637
Provider Business Mailing Address Fax Number:
702-471-0107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 S RANCHO DR STE 34
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89106-4899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-471-0051
Provider Business Practice Location Address Fax Number:
702-471-0107
Provider Enumeration Date:
07/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MOLDOVAN
Authorized Official First Name:
ADRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
702-471-0051

Provider Taxonomy Codes

  • Taxonomy code: 207VX0000X , with the licence number:  8074 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100511202 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".




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