Provider Demographics
NPI:1285907253
Name:TOURO UNIVERSITY
Entity type:Organization
Organization Name:TOURO UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE VICE PRESIDENT FOR ADMIN.
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEIDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:702-777-4794
Mailing Address - Street 1:PO BOX 531730
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89053-1730
Mailing Address - Country:US
Mailing Address - Phone:702-777-3138
Mailing Address - Fax:702-777-2069
Practice Address - Street 1:620 SHADOW LN
Practice Address - Street 2:VALLEY HOSPITAL MEDICAL CENTER
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4119
Practice Address - Country:US
Practice Address - Phone:702-777-4809
Practice Address - Fax:702-777-4822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1266207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1811177454Medicaid
NVDQ530Medicare UPIN