Provider Demographics
NPI:1174649586
Name:KALILI, ROSALIE S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSALIE
Middle Name:S
Last Name:KALILI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8352 W WARM SPRINGS RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3628
Mailing Address - Country:US
Mailing Address - Phone:702-944-4028
Mailing Address - Fax:702-944-4019
Practice Address - Street 1:8352 W WARM SPRINGS RD
Practice Address - Street 2:SUITE 210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3628
Practice Address - Country:US
Practice Address - Phone:702-944-4028
Practice Address - Fax:702-944-4019
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV13191208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500484 GROUPMedicaid
NVWQBHV GROUPMedicare PIN