Organization
GOPENGMD PROF LLC
Active
Other names
LIPOSCULP
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANN UGANIZA (BUSINESS ADMINSTRATOR)
(702) 703-1668
Entity
Organization
Contact information
Practice address
8440 W LAKE MEAD BLVD STE 111, LAS VEGAS, NV 89128-7648
(888) 845-7672
Mailing address
8440 W LAKE MEAD BLVD STE 111, LAS VEGAS, NV 89128-7648
(888) 845-7672
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
08/23/2024
Last updated
09/04/2024
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