Provider Demographics
NPI:1245602390
Name:STEM CELL THERAPY OF LAS VEGAS
Entity Type:Organization
Organization Name:STEM CELL THERAPY OF LAS VEGAS
Other - Org Name:LAMBERT ABEYATUNGE MD FACS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LAMBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABEYATUNGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-936-4770
Mailing Address - Street 1:7231 S EASTERN AVE
Mailing Address - Street 2:SUITE 167
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0451
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2110 E FLAMINGO RD STE 333
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5190
Practice Address - Country:US
Practice Address - Phone:702-936-4770
Practice Address - Fax:702-936-4761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty