Provider Demographics
NPI:1609294594
Name:POMERANZ, MORGAN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:MICHAEL
Last Name:POMERANZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 S CIMARRON RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2157
Mailing Address - Country:US
Mailing Address - Phone:702-562-5832
Mailing Address - Fax:
Practice Address - Street 1:7220 S CIMARRON RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2157
Practice Address - Country:US
Practice Address - Phone:702-384-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLL2759208600000X
390200000X
NV17178208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program