Provider Demographics
NPI:1093391120
Name:FAAMAI, PILI
Entity Type:Individual
Prefix:
First Name:PILI
Middle Name:
Last Name:FAAMAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6615 S EASTERN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-3926
Mailing Address - Country:US
Mailing Address - Phone:702-722-6200
Mailing Address - Fax:702-722-6202
Practice Address - Street 1:6615 S EASTERN AVE STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3926
Practice Address - Country:US
Practice Address - Phone:170-272-2620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV251E0000XOtherHOME HEALTH