Individual
BINNI KOTHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
888 S RANCHO DR, LAS VEGAS, NV 89106-3810
(702) 877-8600
(702) 258-6152
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 877-8600
(702) 258-6152
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1588
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104215250
—
NV
01
—
V109885
SMA MEDICARE
NV
Enumeration date
01/13/2015
Last updated
01/23/2017
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