Provider Demographics
NPI:1205520442
Name:SHIMEKHA, ALVIN (CM)
Entity type:Individual
Prefix:
First Name:ALVIN
Middle Name:
Last Name:SHIMEKHA
Suffix:
Gender:M
Credentials:CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3312 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LV
Mailing Address - State:NV
Mailing Address - Zip Code:89122
Mailing Address - Country:US
Mailing Address - Phone:702-410-7825
Mailing Address - Fax:
Practice Address - Street 1:3312 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LV
Practice Address - State:NV
Practice Address - Zip Code:89122
Practice Address - Country:US
Practice Address - Phone:702-410-7825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator