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Contact Information

CENTERWELL SENIOR PRIMARY CARE (NV) PC
4469 W CHARLESTON BLVD
LAS VEGAS, NV89102-1605
 Phone: 702-832-4561
 Fax: 210-761-3397
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Interventional Cardiology

207RI0011X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CENTERWELL SENIOR PRIMARY CARE (NV) PC

NPI # 1306625835
LBN Legal business name CENTERWELL SENIOR PRIMARY CARE (NV) PC
Authorized official ANGIE MARTINEZ - (SENIOR CREDENTIALING PROFESSIONAL)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/25/2023
Last updated 02/15/2024 - About 2 years ago
Identifiers n/a
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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