Provider Demographics
NPI:1215513155
Name:KASZUBA, BRIAN (MD, DABFM)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:KASZUBA
Suffix:
Gender:M
Credentials:MD, DABFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 EBB TIDE CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1132
Mailing Address - Country:US
Mailing Address - Phone:725-299-4777
Mailing Address - Fax:725-226-2398
Practice Address - Street 1:198 EBB TIDE CIR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1132
Practice Address - Country:US
Practice Address - Phone:725-299-4777
Practice Address - Fax:725-226-2398
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV25897207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine