Basic Information
| Provider Information | |||||||||
| NPI: | 1164647244 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOUCHIR S HARB MD LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6276 S RAINBOW BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891183242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022205557 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6276 S RAINBOW BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891183242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022205557 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2007 | ||||||||
| LastUpdateDate: | 05/05/2011 | ||||||||
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| AuthorizedOfficialLastName: | HARB | ||||||||
| AuthorizedOfficialFirstName: | MOUCHIR | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7022205557 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084S0012X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1164647244 | 01 | NV | GROUP NPI | OTHER |