Provider Demographics
NPI:1376576579
Name:ROBERT R. GAO, M.D. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ROBERT R. GAO, M.D. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:GAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-269-0781
Mailing Address - Street 1:PO BOX 530369
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89053-0369
Mailing Address - Country:US
Mailing Address - Phone:702-269-0781
Mailing Address - Fax:702-269-0788
Practice Address - Street 1:3022 S DURANGO DR STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4440
Practice Address - Country:US
Practice Address - Phone:702-269-0781
Practice Address - Fax:702-269-0788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9991208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCC9211OtherBCBS
NV002018489Medicaid
NVH49692Medicare UPIN
NV1376576579Medicare PIN
NVV36620Medicare PIN
NVCC9211OtherBCBS
NVV36621Medicare PIN