Provider Demographics
NPI:1457783987
Name:ALPINE HOSPITALIST GROUP LLLP
Entity Type:Organization
Organization Name:ALPINE HOSPITALIST GROUP LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHAVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-561-5536
Mailing Address - Street 1:3022 S DURANGO DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3061 S MARYLAND PKWY STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-6226
Practice Address - Country:US
Practice Address - Phone:024-385-5557
Practice Address - Fax:702-438-6666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11478207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty