NPI 1013249788

Canyon Gate Medical Group, LLC

Organisation Family Medicine Physician Las Vegas, NV

Practice location

Address: 10155 W Twain Ave Suite # 110, Las Vegas, NV 89147-6722
Phone: (702) 243-2689
Fax: (702) 243-2632
Mailing address: 2929 N University Dr Suite # 110, Coral Springs, FL 33065-5081

Authorised official

Name: Ricki Moskow
Title: President
Phone: (954) 656-8855

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Nevada →

Registry record

NPI: 1013249788
Entity type: Organization
NPI issued: 5 Feb 2010
Record last updated: 5 Feb 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.