Provider Demographics
NPI:1922197219
Name:SOUTHERN NEVADA ALLERGY PHYSICIANS
Entity type:Organization
Organization Name:SOUTHERN NEVADA ALLERGY PHYSICIANS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALAZAURD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-735-1400
Mailing Address - Street 1:3201 S MARYLAND PARKWAY
Mailing Address - Street 2:306
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108
Mailing Address - Country:US
Mailing Address - Phone:702-735-1400
Mailing Address - Fax:702-735-9273
Practice Address - Street 1:3201 S MARYLAND PARKWAY
Practice Address - Street 2:306
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108
Practice Address - Country:US
Practice Address - Phone:702-735-1400
Practice Address - Fax:702-735-9273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F51365Medicare UPIN
G17662Medicare UPIN