Provider Demographics
NPI:1295819126
Name:DAULAT COMMUNITY FAMILY DOCTORS LTD
Entity Type:Organization
Organization Name:DAULAT COMMUNITY FAMILY DOCTORS LTD
Other - Org Name:COMMUNITY FAMILY DOCTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GIRISH
Authorized Official - Middle Name:H
Authorized Official - Last Name:DAULAT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-873-5100
Mailing Address - Street 1:4500 W OAKEY BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-873-5110
Mailing Address - Fax:702-873-8093
Practice Address - Street 1:4500 W OAKEY BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-873-5110
Practice Address - Fax:702-873-8093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCE9602OtherMEDICARE RAIL-ROAD
NVVWJBFBOtherMEDICARE GROUP