Basic Information
| Provider Information | |||||||||
| NPI: | 1518945260 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATSUNAGA-KIRGAN | ||||||||
| FirstName: | MARSHA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3016 W CHARLESTON BLVD | ||||||||
| Address2: | STE 205 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029684347 | ||||||||
| FaxNumber: | 7023825388 | ||||||||
| Practice Location | |||||||||
| Address1: | UMC - L&D 7TH FLR. | ||||||||
| Address2: | 1800 W CHARLESTON BLVD | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891022329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026712300 | ||||||||
| FaxNumber: | 7026712333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2006 | ||||||||
| LastUpdateDate: | 07/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 8284 | NV | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | FM1781548 | 01 | NV | DEA | OTHER | CS09244 | 01 | NV | PHARMACY/CDS | OTHER | 002018469 | 05 | NV | MEDICAID |