Basic Information
Provider Information
NPI: 1407073273
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: QAZI
FirstName: RIZWAN
MiddleName: ARIF
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 S RANCHO DR
Address2: SUITE 12
City: LAS VEGAS
State: NV
PostalCode: 891064844
CountryCode: US
TelephoneNumber: 7028771887
FaxNumber: 7028774536
Practice Location
Address1: 500 S RANCHO DR
Address2: SUITE 12
City: LAS VEGAS
State: NV
PostalCode: 891064844
CountryCode: US
TelephoneNumber: 7028771887
FaxNumber: 7028774536
Other Information
ProviderEnumerationDate: 04/20/2007
LastUpdateDate: 12/27/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/27/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300X2007001634MON Allopathic & Osteopathic PhysiciansInternal MedicineNephrology
207RN0300X13657NVY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


Home