Organization
JACOB MANJOORAN, MD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB MANJOORAN MD (OWNER)
(702) 480-7825
Entity
Organization
Contact information
Practice address
3680 E SUNSET RD STE 100, LAS VEGAS, NV 89120-7219
(702) 855-0748
(702) 486-4531
Mailing address
2679 BOTHWELL PL, HENDERSON, NV 89044-4400
(702) 480-7825
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
11276
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506295
—
NV
01
—
CC7754
BLUE CROSS BLUE SHIELD
—
Enumeration date
04/25/2012
Last updated
06/03/2013
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