Provider Demographics
NPI:1639157720
Name:EL-MANSOURY, JEYLAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JEYLAN
Middle Name:A
Last Name:EL-MANSOURY
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 1:5871 W CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2575
Mailing Address - Country:US
Mailing Address - Phone:702-724-2020
Mailing Address - Fax:702-724-2800
Practice Address - Street 1:5871 W CRAIG RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2575
Practice Address - Country:US
Practice Address - Phone:702-724-2020
Practice Address - Fax:702-724-2800
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18817207W00000X
PAMD058408L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1643417Medicaid
885603D9LMedicare ID - Type Unspecified
PA1643417Medicaid