Provider Demographics
NPI:1386721157
Name:INFECTIOUS DISEASE ASSOCIATES
Entity type:Organization
Organization Name:INFECTIOUS DISEASE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALKA
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:REBENTISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-868-8387
Mailing Address - Street 1:1450 W HORIZON RIDGE PKWY B304
Mailing Address - Street 2:#668
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012
Mailing Address - Country:US
Mailing Address - Phone:702-868-8387
Mailing Address - Fax:702-314-9134
Practice Address - Street 1:6088 S DURANGO DR STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1780
Practice Address - Country:US
Practice Address - Phone:702-380-4242
Practice Address - Fax:702-380-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RI0200X
NV8061207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2002678Medicaid
1427012806OtherNPI FOR DR. ALKA REBENTIS
NV2002678Medicaid
10533867383OtherNPI FOR DR BRIAN LIPMAN
NV002018716Medicaid
NV2002678Medicaid
1427012806OtherNPI FOR DR. ALKA REBENTIS
E44639Medicare UPIN
V31971Medicare ID - Type UnspecifiedFOR PRACTICE