# SHADOW MOUNTAIN SURGERY CENTER

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

## Provider details

- **NPI number:** 1730280330
- **Authorized official:** DR. DAVID I MALITZ MD (OWNER)
- **Authorized official phone:** (812) 421-2020

## Contact information

- **Practice address:** 7135 W SAHARA AVE, LAS VEGAS, NV 89117-2828
- **Practice address phone:** (812) 421-2020
- **Practice address fax:** (812) 422-1189
- **Mailing address:** 7135 W SAHARA AVE, LAS VEGAS, NV 89117-2828
- **Mailing address phone:** (812) 421-2020
- **Mailing address fax:** (812) 422-1189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2000044-426 | NV | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 10/23/2007