Most Relevant Information
Provider Data
| NPI Number: | 1003468125 |
| Provider Name: | MITRA JEIZAN |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/09/2019 |
| Last Updated: | 07/09/2019 |
Provider Practice Location
8290 W SAHARA AVE STE 260
LAS VEGAS
NV
891178933
Practice Location Phone/Fax
| Phone: | 7022629949 |
| Fax: |
Provider Mailing Location
8290 W SAHARA AVE STE 260
LAS VEGAS
NV
891178933
Provider Mailing Phone/Fax
| Phone: | 7022629949 |
| Fax: |