Organization
REZA MOJTABAVI, M.D. PLLC
Active
Other names
Avencia Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
REZA MOJTABAVI (OWNER)
(702) 445-7770
Entity
Organization
Contact information
Practice address
3150 N TENAYA WAY, SUITE 240, LAS VEGAS, NV 89128-0443
(702) 445-7770
(702) 445-7772
Mailing address
PO BOX 34707, LAS VEGAS, NV 89133-4707
(702) 445-7770
(702) 445-7772
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13155
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952530578
—
NV
Enumeration date
07/02/2009
Last updated
12/22/2016
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