Provider Demographics
NPI:1891403952
Name:LVSA ON CALL PLLC
Entity Type:Organization
Organization Name:LVSA ON CALL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARAVELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MBR
Authorized Official - Phone:702-258-7788
Mailing Address - Street 1:8930 W SUNSET RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5013
Mailing Address - Country:US
Mailing Address - Phone:702-258-7788
Mailing Address - Fax:
Practice Address - Street 1:8930 W SUNSET RD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5013
Practice Address - Country:US
Practice Address - Phone:702-258-7788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV10155OtherSTATE LIC