Provider Demographics
NPI:1932837218
Name:NV HEALTHCARE LLC
Entity Type:Organization
Organization Name:NV HEALTHCARE LLC
Other - Org Name:NV HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:KHUONG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:951-581-0723
Mailing Address - Street 1:30439 MAHOGANY ST
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-3533
Mailing Address - Country:US
Mailing Address - Phone:951-581-0723
Mailing Address - Fax:
Practice Address - Street 1:3838 RAYMERT DR # 21
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3247
Practice Address - Country:US
Practice Address - Phone:702-927-3230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-12
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care