Provider Demographics
NPI:1497924468
Name:JANDA, PAUL HARLAN (DO, JD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:HARLAN
Last Name:JANDA
Suffix:
Gender:M
Credentials:DO, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 VILLAGE CENTER CIR STE 3-717
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6299
Mailing Address - Country:US
Mailing Address - Phone:702-432-2233
Mailing Address - Fax:702-800-5456
Practice Address - Street 1:2020 WELLNESS WAY STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4145
Practice Address - Country:US
Practice Address - Phone:702-432-2233
Practice Address - Fax:702-800-5456
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO15882084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVGA593ZMedicare PIN