Organization
INTERMOUNTAIN MEDICAL HOLDING NEVADA, INC.
Active
Parent organization
INTERMOUNTAIN MEDICAL HOLDING NEVADA, INC.
Other names
San Martin Clinic, Healthcare Partners Medical Group, Intermountain Healthcare
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN MEDICAL HOLDING NEVADA, INC.
Authorized official
MITCH CLOWARD (REGION PRESIDENT)
(702) 216-3346
Entity
Organization
Contact information
Practice address
8285 W. ARBY AVE., SUITE #100, LAS VEGAS, NV 89113-2239
(702) 735-7154
(702) 405-1860
Mailing address
6355 S BUFFALO DR, LAS VEGAS, NV 89113-2133
(702) 216-3346
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043533383
—
NV
05
—
1245997279
—
NV
05
—
1326261298
—
NV
Enumeration date
04/10/2007
Last updated
01/14/2025
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