Provider Demographics
NPI:1851080147
Name:HEALTHY YOU MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:HEALTHY YOU MEDICAL GROUP LLC
Other - Org Name:HEALTHY YOU MEDICAL GROUP LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IRENEO
Authorized Official - Middle Name:LAZO
Authorized Official - Last Name:GUIKING
Authorized Official - Suffix:JR
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-425-0172
Mailing Address - Street 1:8290 W SAHARA AVE STE 152
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8932
Mailing Address - Country:US
Mailing Address - Phone:702-425-0172
Mailing Address - Fax:
Practice Address - Street 1:8290 W SAHARA AVE STE 152
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8932
Practice Address - Country:US
Practice Address - Phone:702-900-9753
Practice Address - Fax:702-900-9982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty