Provider Demographics
NPI:1508618976
Name:ZEYNALOV, ELSHAN
Entity Type:Individual
Prefix:
First Name:ELSHAN
Middle Name:
Last Name:ZEYNALOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 DEAN MARTIN DR UNIT 119
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3581
Mailing Address - Country:US
Mailing Address - Phone:702-540-2489
Mailing Address - Fax:
Practice Address - Street 1:10650 DEAN MARTIN DR UNIT 119
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-3581
Practice Address - Country:US
Practice Address - Phone:702-540-2489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver