ERIC MOLDESTAD (NPI# 1104018951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104018951 |
Entity Type | Individual |
Full Name | ERIC MOLDESTAD |
Credential | MD |
Practice Address |
2020 Palomino Lane Ste 100 Las Vegas NV 89106-4894 |
Practice Telephone | 7027598600 |
Practice Fax Number | 7023841815 |
Mailing Telephone | 7027598600 |
Mailing Fax Number | 7023841815 |
Enumeration Date | 2007-08-15 |
Last Update Date | 2014-08-11 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
14294 | NV | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 1104018951 | 05 | |
OK | 200471140A | 05 | |
NV | 1104018951 | 05 | |
NV | RAILROAD MEDICARE | P01077444 | 01 |
Street Address |
2020 PALOMINO LANE STE 100 |
City | LAS VEGAS |
State | NV |
Zip Code | 89106-4894 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023078987 | Joshua Rosenberg | Radiology | 2020 Palomino Lane, Ste # 100, Las Vegas, NV 89106-4894 | 2006-03-24 |
1043534654 | Karen B Alderfer | Radiology | 2020 Palomino Lane, Ste # 100, Las Vegas, NV 89106-4894 | 2010-03-25 |
1538398573 | Sukhjinder Pal Singh | Radiology | 2020 Palomino Lane, Ste # 100, Las Vegas, NV 89106-4894 | 2009-07-13 |
1831324011 | Kevin Mohtashemi | Radiology | 2020 Palomino Lane, Ste # 100, Las Vegas, NV 89106-4894 | 2009-05-18 |
1194979856 | Neil Vinny Kaura | Radiology | 2020 Palomino Lane, Ste # 100, Las Vegas, NV 89106-4894 | 2008-11-07 |
1821254830 | Rick Yeh | Radiology | 2020 Palomino Lane, Ste 100, Las Vegas, NV 89106-4894 | 2008-07-30 |
1477714525 | Elan Dahl Bomsztyk | Radiology | 2020 Palomino Lane, Ste # 100, Las Vegas, NV 89106-4894 | 2008-06-21 |
1659559334 | Trey Quang Pham | Radiology | 2020 Palomino Lane, # 100, Las Vegas, NV 89106-4894 | 2008-02-05 |
1285830828 | Sandra Maureen Lee | Radiology | 2020 Palomino Lane, Ste # 100, Las Vegas, NV 89106-4894 | 2007-06-21 |
1497956635 | Benjamin Morgan Muir | Radiology | 2020 Palomino Lane, Suite 100, Las Vegas, NV 89106-4894 | 2007-05-28 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
Find all providers in zip 89106 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
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1346860624 | Smi Imaging LLC | Radiology | 7455 W Washington Ave Ste 120, Las Vegas, NV 89128-4338 | 2020-04-16 |
1548807274 | Smi Imaging LLC | Radiology | 3560 W Flamingo Rd, Ste 100, Las Vegas, NV 89121-5088 | 2019-12-02 |
1316583297 | Smi Imaging LLC | Radiology | 8530 W Sunset Rd Ste 120, Las Vegas, NV 89113-2244 | 2019-11-26 |
1114563095 | Smi Imaging LLC | Radiology | 7540 Oso Blanca Rd Ste 140, Las Vegas, NV 89149-1417 | 2019-11-26 |
1396381273 | Smi Imaging LLC | Radiology | 7610 W Cheyenne Ave Ste 100, Las Vegas, NV 89129-6761 | 2019-11-26 |
1740826627 | Smi Imaging LLC | Radiology | 3061 S Maryland Pkwy Ste 102, Las Vegas, NV 89109-6226 | 2019-11-26 |
1366000622 | 6radiology | Radiology | 11266 Parleys Cone Ct, Las Vegas, NV 89135-1839 | 2019-06-03 |
1396271698 | Cheryl Jayne | Radiology | 2225 Scarlet Rose Dr, Las Vegas, NV 89134-5905 | 2017-05-04 |
1174997407 | Sutter Valley Medical Foundation | Radiology | 2995 American River Ln, Las Vegas, NV 89135-1713 | 2015-11-24 |
1467879205 | Ross Leon Prujan | Radiology | 11663 Glowing Sunset Ln, Las Vegas, NV 89135-1659 | 2014-03-18 |
Find all providers in LAS VEGAS |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.