Individual
DR. JACK EBRAHIMPOUR ABRAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6450 MEDICAL CENTER ST, SUITE 100, LAS VEGAS, NV 89148-2442
(702) 304-9494
(702) 304-9495
Mailing address
4800 N 22ND ST STE 210, PHOENIX, AZ 85016-4963
(702) 304-9494
(702) 304-9495
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9777
NV
207W00000X
Ophthalmology Physician
9777
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018382
—
NV
Enumeration date
07/22/2005
Last updated
05/24/2022
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