Provider Demographics
NPI:1487687539
Name:LAS VEGAS SKIN AND CANCER CLINICS LTD
Entity Type:Organization
Organization Name:LAS VEGAS SKIN AND CANCER CLINICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-436-1001
Mailing Address - Street 1:2851 BUSINESS PARK CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-9005
Mailing Address - Country:US
Mailing Address - Phone:702-360-2100
Mailing Address - Fax:702-360-3201
Practice Address - Street 1:4488 S PECOS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5030
Practice Address - Country:US
Practice Address - Phone:702-436-1001
Practice Address - Fax:702-436-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WCCDPMedicare ID - Type UnspecifiedMEDICARE GROUP