Individual
DR. KEITH G BOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 S RANCHO DR, STE. D-28, LAS VEGAS, NV 89106-4899
(702) 383-0677
(702) 383-0688
Mailing address
9260 W. SUNSET RD, STE200, LAS VEGAS, NV 89148-4903
(702) 255-3547
(702) 921-2419
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NV4089
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002002951
—
NV
01
—
NV 2996
BC/BS INDENTIFIER
NV
Enumeration date
06/01/2005
Last updated
03/07/2023
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