Provider Demographics
NPI:1881411445
Name:ANGELES MEDICAL CENTER LLC
Entity type:Organization
Organization Name:ANGELES MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-379-2396
Mailing Address - Street 1:2123 CIVIC CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6327
Mailing Address - Country:US
Mailing Address - Phone:702-333-0110
Mailing Address - Fax:
Practice Address - Street 1:2123 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6327
Practice Address - Country:US
Practice Address - Phone:702-333-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty