Provider Demographics
NPI:1194707547
Name:MOLIN, CLIFFORD JOEL (MD)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:JOEL
Last Name:MOLIN
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 1:2481 PROFESSIONAL CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0825
Mailing Address - Country:US
Mailing Address - Phone:702-382-1599
Mailing Address - Fax:702-240-4962
Practice Address - Street 1:2481 PROFESSIONAL CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0825
Practice Address - Country:US
Practice Address - Phone:702-382-1599
Practice Address - Fax:702-240-4962
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9580207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1194707547Medicaid
NVV100820Medicare PIN
NV1194707547Medicaid