Basic Information
| Provider Information | |||||||||
| NPI: | 1013198738 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOFIA TSELIKIS MD LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2251 N RAMPART BLVD | ||||||||
| Address2: | #376 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891287640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028603467 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3100 N TENAYA WAY | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891280436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024533799 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2007 | ||||||||
| LastUpdateDate: | 01/24/2008 | ||||||||
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| AuthorizedOfficialLastName: | TSELIKIS | ||||||||
| AuthorizedOfficialFirstName: | SOFIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7024533799 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 11034 | NV | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.