Provider Demographics
NPI:1043784929
Name:RED ROCK HOSPITALIST GROUP P.C.
Entity Type:Organization
Organization Name:RED ROCK HOSPITALIST GROUP P.C.
Other - Org Name:RED ROCK FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-910-2800
Mailing Address - Street 1:2850 S JONES BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5640
Mailing Address - Country:US
Mailing Address - Phone:702-910-2800
Mailing Address - Fax:
Practice Address - Street 1:2850 S JONES BLVD STE 1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5640
Practice Address - Country:US
Practice Address - Phone:702-910-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty