Provider Demographics
NPI:1457731242
Name:JANDA, MAHAJAN & BALSIGER PLLC
Entity Type:Organization
Organization Name:JANDA, MAHAJAN & BALSIGER PLLC
Other - Org Name:LAS VEGAS, NEUROLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:TRUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-432-2233
Mailing Address - Street 1:1930 VILLAGE CENTER CIRCLE 3-717
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134
Mailing Address - Country:US
Mailing Address - Phone:702-432-2233
Mailing Address - Fax:702-800-5456
Practice Address - Street 1:2020 WELLNESS WAY STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4145
Practice Address - Country:US
Practice Address - Phone:702-432-2233
Practice Address - Fax:702-800-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084N0400X
NV2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100526649Medicaid