Organization
I-STAT PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJEEV KALRA MD (PRESIDENT)
(626) 290-1056
Entity
Organization
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(626) 290-1056
Mailing address
6260 TUCKAWAY COVE AVE, LAS VEGAS, NV 89139-6269
(626) 290-1056
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154583870
—
NV
Enumeration date
02/18/2022
Last updated
03/16/2022
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