Provider Demographics
NPI:1104850163
Name:CONCIERGE CARE PHYSICIANS, LLP
Entity Type:Organization
Organization Name:CONCIERGE CARE PHYSICIANS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:N
Authorized Official - Last Name:NEIBAUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-990-0622
Mailing Address - Street 1:2450 W HORIZON RIDGE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2722
Mailing Address - Country:US
Mailing Address - Phone:702-990-0622
Mailing Address - Fax:702-938-1473
Practice Address - Street 1:2450 W HORIZON RIDGE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2722
Practice Address - Country:US
Practice Address - Phone:702-990-0622
Practice Address - Fax:702-938-1473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty