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Specialty details in registry · Las Vegas, NV

Call (732) 515-5511 Directions

At a glance

5860 Wynn Rd Ste B, Las Vegas, NV 89118-3063

NPPES record updated Apr 3, 2026. Public records can lag behind changes at a practice.

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Practice location

5860 Wynn Rd Ste B
Las Vegas, NV 89118-3063

Professional details: NPI, taxonomy & registry record

NPI1245720010

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 332B00000X
Enumeration date: May 16, 2018
Record updated: Apr 3, 2026

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

332B00000X · Primary

Specialty details in registry

332BC3200X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

5860 Wynn Rd Ste B
Las Vegas, NV 89118-3063

Phone: (732) 515-5511

Mailing address

5860 WYNN RD STE B

LAS VEGAS, NV 891183063

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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