Organization
DESERT SHADOW ENDOCOPY CENTER, LLC
Active
Other names
Desert Shadow Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
DIPAK DESAI M.D. (DIRECTOR)
(702) 220-5601
Entity
Organization
Contact information
Practice address
4275 BURNHAM AVE, SUITE #101, LAS VEGAS, NV 89119-5488
(702) 220-5601
(702) 227-3076
Mailing address
PO BOX 35140, LAS VEGAS, NV 89133-5140
(702) 220-5601
(702) 227-3076
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
4493ASC-0
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100510771
—
NV
Enumeration date
08/31/2006
Last updated
06/27/2008
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