1144214750 NPI number — GASTROENTEROLOGY CENTER OF NEVADA, LLP (DESAI)

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144214750 NPI number — GASTROENTEROLOGY CENTER OF NEVADA, LLP (DESAI)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GASTROENTEROLOGY CENTER OF NEVADA, LLP (DESAI)
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:
Provider Other Organization Name Type Code:
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:
1144214750
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 SHADOW LN
Provider Second Line Business Mailing Address:
SUITE #165A
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89106-4126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-928-8101
Provider Business Mailing Address Fax Number:
702-382-0803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 SHADOW LN
Provider Second Line Business Practice Location Address:
SUITE #165A
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89106-4126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-928-8101
Provider Business Practice Location Address Fax Number:
702-382-0803
Provider Enumeration Date:
09/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DESAI
Authorized Official First Name:
DIPAK
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/MEMBER
Authorized Official Telephone Number:
702-382-8101

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , 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)





Copyright © 2007-2025 www.npivalidator.com