Provider Demographics
NPI:1962610345
Name:KHALEK & TAFRESHI,LLP
Entity type:Organization
Organization Name:KHALEK & TAFRESHI,LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFRESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-258-8100
Mailing Address - Street 1:4500 MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-2916
Mailing Address - Country:US
Mailing Address - Phone:702-258-8100
Mailing Address - Fax:702-258-4244
Practice Address - Street 1:4500 MEADOWS LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-2916
Practice Address - Country:US
Practice Address - Phone:702-258-8100
Practice Address - Fax:702-258-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVF54785Medicare UPIN
NVF65101Medicare UPIN
NVH04060Medicare UPIN