Organization
REZA MOJTABAVI, M.D. PLLC
Active
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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