Provider Demographics
NPI:1518196765
Name:OBAND BERNSTEIN MEDICAL GROUP, LTD
Entity Type:Organization
Organization Name:OBAND BERNSTEIN MEDICAL GROUP, LTD
Other - Org Name:OBAND MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-487-6000
Mailing Address - Street 1:4440 SOUTH EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7825
Mailing Address - Country:US
Mailing Address - Phone:702-487-6000
Mailing Address - Fax:702-487-6006
Practice Address - Street 1:4440 SOUTH EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7825
Practice Address - Country:US
Practice Address - Phone:702-487-6000
Practice Address - Fax:702-487-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty