Provider Demographics
NPI:1659782910
Name:ANDAR, HAROON (DO)
Entity Type:Individual
Prefix:
First Name:HAROON
Middle Name:
Last Name:ANDAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6545 S FORT APACHE ROAD STE 135
Mailing Address - Street 2:#466
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148
Mailing Address - Country:US
Mailing Address - Phone:510-861-3990
Mailing Address - Fax:
Practice Address - Street 1:6064 S FORT APACHE RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5350
Practice Address - Country:US
Practice Address - Phone:702-940-8007
Practice Address - Fax:702-832-1940
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO3052208VP0014X
FLOS14286208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101818100Medicaid
FL33IKLOtherBCBS