Provider Demographics
NPI:1225645682
Name:RAJIV P AMESUR DO PC
Entity Type:Organization
Organization Name:RAJIV P AMESUR DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:PRADEEP
Authorized Official - Last Name:AMESUR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-781-4800
Mailing Address - Street 1:3459 SAINT ROSE PKWY STE 120-481
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4601
Mailing Address - Country:US
Mailing Address - Phone:702-781-4800
Mailing Address - Fax:702-664-6755
Practice Address - Street 1:1669 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3516
Practice Address - Country:US
Practice Address - Phone:702-781-4800
Practice Address - Fax:702-664-6755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty