# PACIFIC WEST UROLOGY LLC A PROFESSIONAL MEDICAL COMPANY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629607940
- **Authorized official:** DR. JOEL EMMANUEL ABBOTT DO (PHYSICIAN/OWNER)
- **Authorized official phone:** (702) 715-4155

## Contact information

- **Practice address:** 6110 ELTON AVE, LAS VEGAS, NV 89107-2538
- **Practice address phone:** (702) 906-2976
- **Mailing address:** 4313 CORAN LN, LAS VEGAS, NV 89108-2844
- **Mailing address phone:** (702) 715-4155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/07/2020
- **Last updated:** 04/07/2020