Provider Demographics
NPI:1548335110
Name:SOUTH MCCARRAN URGENT CARE
Entity type:Organization
Organization Name:SOUTH MCCARRAN URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:775-826-8100
Mailing Address - Street 1:3967 S MCCARRAN BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-7510
Mailing Address - Country:US
Mailing Address - Phone:775-824-4700
Mailing Address - Fax:775-823-2106
Practice Address - Street 1:3967 S MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-7510
Practice Address - Country:US
Practice Address - Phone:775-824-4700
Practice Address - Fax:775-823-2106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty