Provider Demographics
NPI:1578586640
Name:TULADHAR, PREETI (MD)
Entity Type:Individual
Prefix:DR
First Name:PREETI
Middle Name:
Last Name:TULADHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 PALOMINO LANE
Mailing Address - Street 2:STE # 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4894
Mailing Address - Country:US
Mailing Address - Phone:702-759-8600
Mailing Address - Fax:702-384-1815
Practice Address - Street 1:2020 PALOMINO LANE
Practice Address - Street 2:SUITE # 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4894
Practice Address - Country:US
Practice Address - Phone:702-759-8600
Practice Address - Fax:702-384-1815
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ376832085R0202X
CAA949442085R0202X
NV158482085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578586640Medicaid
AZ277934Medicaid
CAP01558103OtherRR MEDICARE DRS
CAP01672396OtherRR MEDICARE DR
AZ277934Medicaid
CACB230217Medicare PIN
CAP01672396OtherRR MEDICARE DR
CACA145830Medicare PIN
AZZ119265Medicare PIN
CACA148458Medicare PIN
AZZI66321Medicare PIN
AZZ111681Medicare PIN
CAP01558103OtherRR MEDICARE DRS
AZZ113089Medicare PIN
AZZ107628Medicare PIN