OrganizationActive
Gastrointestinal Diagnostic Clinic
NPI 1811085459 · Ambulatory Surgical Clinic/Center · Las Vegas, NV
Provider details
- NPI number
- 1811085459
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Jack London, Senior Consultant
- License
- 477ASC-8 (NV)
Practice location
3196 S Maryland Pkwy
Suite 207
Las Vegas, NV 89109-2305
Phone: (702) 369-3400
Mailing address
3196 S Maryland Pkwy
Las Vegas, NV 89109-2305
Registry dates
- Enumerated
- 2006-10-10
- Last updated
- 2007-10-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.