Provider Demographics
NPI:1578767836
Name:DHANVANTARI TREHAN SALTS OF THE EARTH PC
Entity Type:Organization
Organization Name:DHANVANTARI TREHAN SALTS OF THE EARTH PC
Other - Org Name:HELIOS DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DESIGNEE
Authorized Official - Prefix:DR
Authorized Official - First Name:MANJU
Authorized Official - Middle Name:MONIKA
Authorized Official - Last Name:TREHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-343-3522
Mailing Address - Street 1:9811 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE # 2278
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7528
Mailing Address - Country:US
Mailing Address - Phone:702-343-3522
Mailing Address - Fax:702-877-3376
Practice Address - Street 1:653 N TOWN CENTER DR
Practice Address - Street 2:SUITE # 400
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0514
Practice Address - Country:US
Practice Address - Phone:702-343-3522
Practice Address - Fax:702-877-3376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11042207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507842Medicaid
NV100507842Medicaid
NVV101993Medicare PIN