Provider Demographics
NPI:1356585350
Name:GOROSH, LOREN ROWE (MD)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:ROWE
Last Name:GOROSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 RANCHO LN
Mailing Address - Street 2:SUITE 135
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3836
Mailing Address - Country:US
Mailing Address - Phone:702-383-7885
Mailing Address - Fax:
Practice Address - Street 1:901 RANCHO LN
Practice Address - Street 2:SUITE 135
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3836
Practice Address - Country:US
Practice Address - Phone:702-383-7885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14388207P00000X
AZ45589207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine