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Contact Information

INDEPENDENT MEDICAL GROUP, LLC
1320 E CALVADA BLVD
PAHRUMP, NV89048-5692
 Phone: 775-751-6111
 Fax: 775-751-3056
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for INDEPENDENT MEDICAL GROUP, LLC

NPI # 1942843859
LBN Legal business name INDEPENDENT MEDICAL GROUP, LLC
Authorized official MICHAEL REINER - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/23/2019
Last updated 12/13/2019 - About 6 years ago
Identifiers
NV Medicaid 2012042
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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