Provider Demographics
NPI:1811226400
Name:PROFESSIONAL MEDICAL MANAGEMENT, INC.
Entity type:Organization
Organization Name:PROFESSIONAL MEDICAL MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-454-8236
Mailing Address - Street 1:3230 E FLAMINGO RD
Mailing Address - Street 2:334
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4320
Mailing Address - Country:US
Mailing Address - Phone:702-454-8236
Mailing Address - Fax:702-454-8279
Practice Address - Street 1:3230 E FLAMINGO RD
Practice Address - Street 2:334
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4320
Practice Address - Country:US
Practice Address - Phone:702-454-8236
Practice Address - Fax:702-454-8279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV010-1001168755207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Single Specialty