Provider Demographics
NPI:1578840724
Name:ALBION MEDICAL GROUP OF NEVADA, PC
Entity Type:Organization
Organization Name:ALBION MEDICAL GROUP OF NEVADA, PC
Other - Org Name:CAREMORE MEDICAL GROUP OF NEVADA (WORKU), PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALBION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:242-345-0252
Mailing Address - Street 1:12900 PARK PLAZA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9329
Mailing Address - Country:US
Mailing Address - Phone:562-622-2800
Mailing Address - Fax:562-741-4479
Practice Address - Street 1:3041 E FLAMINGO RD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7447
Practice Address - Country:US
Practice Address - Phone:702-436-0835
Practice Address - Fax:702-435-6212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty