Organization
MEDICAL ASSOCIATES OF SOUTHERN NEVADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GOVIND VENKATA KOKA DO (PRESIDENT)
(702) 492-7208
Entity
Organization
Contact information
Practice address
9975 S EASTERN AVE, 110A, LAS VEGAS, NV 89183-7949
(702) 492-7208
(702) 407-5645
Mailing address
PO BOX 778195, HENDERSON, NV 89077-8195
(702) 492-7208
(702) 407-5645
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
1001
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NV1001
DO LICENSE NV1001
NV
Enumeration date
10/22/2010
Last updated
10/22/2010
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