Provider Demographics
NPI:1306364914
Name:VIP SURG (TSUDA RYAN), PLLC
Entity Type:Organization
Organization Name:VIP SURG (TSUDA RYAN), PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:TSUDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-500-1646
Mailing Address - Street 1:PO BOX 34270
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-4270
Mailing Address - Country:US
Mailing Address - Phone:702-500-1646
Mailing Address - Fax:702-487-6006
Practice Address - Street 1:653 N TOWN CENTER DR STE 510
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0519
Practice Address - Country:US
Practice Address - Phone:702-448-5578
Practice Address - Fax:702-703-2375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-03
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty