# HEART MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heart Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962050716
- **Authorized official:** VIVIAN OWYONG (AGENT)
- **Authorized official phone:** (702) 235-5778

## Contact information

- **Practice address:** 1210 S VALLEY VIEW BLVD, UNIT 102, LAS VEGAS, NV 89102
- **Practice address phone:** (702) 235-5778
- **Mailing address:** 1210 S VALLEY VIEW BLVD, UNIT 102, LAS VEGAS, NV 89102
- **Mailing address phone:** (702) 235-5778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/26/2019
- **Last updated:** 12/30/2019