Provider Demographics
NPI:1891930392
Name:LAS VEGAS SURGERY CENTER LLC
Entity Type:Organization
Organization Name:LAS VEGAS SURGERY CENTER LLC
Other - Org Name:RED ROCK SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:IRWIN
Authorized Official - Last Name:MALITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-227-5848
Mailing Address - Street 1:7135 W SAHARA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2828
Mailing Address - Country:US
Mailing Address - Phone:702-227-5848
Mailing Address - Fax:702-227-5849
Practice Address - Street 1:7135 W SAHARA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2828
Practice Address - Country:US
Practice Address - Phone:702-227-5848
Practice Address - Fax:702-227-5849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3066ASC-12261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
V34468AMedicare PIN
29C0001074Medicare Oscar/Certification