Provider Demographics
NPI:1528291010
Name:LAS VEGAS WEST INC
Entity type:Organization
Organization Name:LAS VEGAS WEST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:604-599-1895
Mailing Address - Street 1:8751 W CHARLESTON BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5484
Mailing Address - Country:US
Mailing Address - Phone:604-599-1895
Mailing Address - Fax:604-599-1891
Practice Address - Street 1:8751 W CHARLESTON BLVD STE 250
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5484
Practice Address - Country:US
Practice Address - Phone:604-599-1895
Practice Address - Fax:604-599-1891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPT1469208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV104133Medicare PIN