Provider Demographics
NPI:1104873876
Name:LAGSTEIN, ZEV (MD)
Entity type:Individual
Prefix:DR
First Name:ZEV
Middle Name:
Last Name:LAGSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28910
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89126-2910
Mailing Address - Country:US
Mailing Address - Phone:702-870-1026
Mailing Address - Fax:702-870-4249
Practice Address - Street 1:3017 W CHARLESTON BLVD STE 80
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-870-1026
Practice Address - Fax:702-870-4249
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3656207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2670401OtherAETNA ID#
NV880175164OtherFEDERAL TAX ID#
NV002002862Medicaid
NV0774328000OtherBC/BS ID#
NV0774328000OtherBC/BS ID#
NV002002862Medicaid