Provider Demographics
NPI:1912110677
Name:GENERAL SURGICAL CONSULTANTS LLC
Entity Type:Organization
Organization Name:GENERAL SURGICAL CONSULTANTS LLC
Other - Org Name:GARY S. MONO, D.O. & DENNIS CHONG, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:STOTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-617-1981
Mailing Address - Street 1:10001 S EASTERN AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3908
Mailing Address - Country:US
Mailing Address - Phone:702-617-1981
Mailing Address - Fax:702-616-1105
Practice Address - Street 1:10001 S EASTERN AVE STE 206
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3908
Practice Address - Country:US
Practice Address - Phone:702-617-1981
Practice Address - Fax:702-616-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1912110677Medicaid
NV26713OtherBCBS
NV26713OtherBCBS