Provider Demographics
NPI:1811015357
Name:DR BIFF MCCANN PROF CORP
Entity Type:Organization
Organization Name:DR BIFF MCCANN PROF CORP
Other - Org Name:DR. BIFF MCCANN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:BIFF
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-360-9500
Mailing Address - Street 1:10300 W CHARLESTON BLVD
Mailing Address - Street 2:#13-191
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1037
Mailing Address - Country:US
Mailing Address - Phone:702-360-9500
Mailing Address - Fax:702-360-9547
Practice Address - Street 1:8685 W SAHARA AVE
Practice Address - Street 2:#180
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5880
Practice Address - Country:US
Practice Address - Phone:702-360-9500
Practice Address - Fax:702-360-9547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8640208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2018030Medicaid
NV2018030Medicaid
NVG69071Medicare UPIN