Organization
GOLDSMITH HEALTHCARE, LTD
Active
Other names
INNOVATIVE CARE PHYSICIANS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN LEE GOLDSMITH M.D. (OWNER/DIRECTOR)
(702) 367-0808
Entity
Organization
Contact information
Practice address
5375 S FORT APACHE RD, LAS VEGAS, NV 89148-7623
(702) 367-0808
(702) 367-1339
Mailing address
5375 S FORT APACHE RD, #102-103, LAS VEGAS, NV 89148-7623
(702) 646-9444
(702) 646-9022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6116
NV
207R00000X
Internal Medicine Physician
Primary
6116
NV
363A00000X
Physician Assistant
PA1149
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019160
—
NV
01
—
6116
NV MEDICAL LICENSE
NV
Enumeration date
04/26/2006
Last updated
08/06/2014
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