Provider Demographics
NPI:1508544743
Name:ADVANCED RHEUMATOLOGY ASSOCIATES OF NEVADA MODJINOU PLLC
Entity Type:Organization
Organization Name:ADVANCED RHEUMATOLOGY ASSOCIATES OF NEVADA MODJINOU PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-413-2177
Mailing Address - Street 1:861 CORONADO CENTER DR STE 220
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3992
Mailing Address - Country:US
Mailing Address - Phone:702-984-3776
Mailing Address - Fax:
Practice Address - Street 1:861 CORONADO CENTER DR STE 220
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3992
Practice Address - Country:US
Practice Address - Phone:702-984-3776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty