Basic Information
Provider Information
NPI: 1811972565
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADRANGI
FirstName: BAHBAK
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3157 N RAINBOW BLVD # 518
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891084578
CountryCode: US
TelephoneNumber: 7023864700
FaxNumber: 7023864701
Practice Location
Address1: 7250 PEAK DR STE 100
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891289028
CountryCode: US
TelephoneNumber: 7023864700
FaxNumber: 7023864701
Other Information
ProviderEnumerationDate: 12/14/2005
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X9956NVY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
62151701AZARIZONA MEDICAIDOTHER
00201863005NV MEDICAID


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