Individual
FAEZEH IZADMANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9010 W CHEYENNE AVE, LAS VEGAS, NV 89129-8932
(702) 240-8646
(702) 240-0206
Mailing address
9010 W CHEYENNE AVE, LAS VEGAS, NV 89129-8932
(702) 240-8646
(702) 240-0206
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13589
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487836748
—
NV
Enumeration date
11/28/2007
Last updated
10/06/2014
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