Organization
KOSE ISEH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MFON PETER ISEH MD (OWNER OF ENTITY)
(702) 768-9291
Entity
Organization
Contact information
Practice address
6166 N DURANGO DR, LAS VEGAS, NV 89149-3912
(725) 223-4100
Mailing address
10470 W CHEYENNE AVENUE, STE 115, PMB 311, LAS VEGAS, NV 89129
(702) 202-4534
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
07/23/2020
Last updated
03/23/2021
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