Provider Demographics
NPI:1518190172
Name:ROYAL CENTER FOR ADVANCED MEDICINE
Entity Type:Organization
Organization Name:ROYAL CENTER FOR ADVANCED MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-836-0961
Mailing Address - Street 1:9065 S PECOS RD
Mailing Address - Street 2:SUITE #240
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7187
Mailing Address - Country:US
Mailing Address - Phone:702-836-0961
Mailing Address - Fax:702-836-0964
Practice Address - Street 1:9065 S PECOS RD
Practice Address - Street 2:SUITE #240
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7187
Practice Address - Country:US
Practice Address - Phone:702-836-0961
Practice Address - Fax:702-836-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty