Provider Demographics
NPI:1275808099
Name:PAUL H JANDA DO PC
Entity Type:Organization
Organization Name:PAUL H JANDA DO PC
Other - Org Name:LAS VEGAS NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:JANDA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-685-1400
Mailing Address - Street 1:7345 S DURANGO DR # B107-307
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3653
Mailing Address - Country:US
Mailing Address - Phone:702-625-4400
Mailing Address - Fax:702-800-5456
Practice Address - Street 1:2020 GOLDRING AVE STE 202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4055
Practice Address - Country:US
Practice Address - Phone:702-685-1400
Practice Address - Fax:702-800-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVGA592AMedicare PIN