Basic Information
| Provider Information | |||||||||
| NPI: | 1255922084 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SALTANAT MEDICAL LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3022 S DURANGO DR STE 100 | ||||||||
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| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891174440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022563637 | ||||||||
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| Practice Location | |||||||||
| Address1: | 229 N PECOS RD STE 120 | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890747364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026297510 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2021 | ||||||||
| LastUpdateDate: | 02/03/2021 | ||||||||
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| AuthorizedOfficialLastName: | YOUSEFI | ||||||||
| AuthorizedOfficialFirstName: | FAYSAL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6317934531 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.