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Organization

CHOICE FAMILY MEDICAL CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LETANIYA WARREN TATUM (OWNER)
(702) 680-0600
Entity
Organization

Contact information

Practice address
4185 VEGAS VALLEY DR STE C, LAS VEGAS, NV 89121-2522
(702) 463-9066
(702) 463-9067
Mailing address
400 N STEPHANIE ST STE 260, HENDERSON, NV 89014-6800
(702) 629-5555

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261QP2300X
Primary Care Clinic/Center
261QU0200X
Urgent Care Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2500010169
NV
01
NV20201837431
STATE OF NEVADA
NV
Enumeration date
07/24/2020
Last updated
04/06/2022
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