Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 57175 | CA |
Y | 213EG0000X | General Practice | 57175 | CA |
NPI | 1003062985 |
---|---|
Provider Name | Dr. Alister Yi-Heng Man |
First Address | Las Vegas, NV 89129-8923 |
Second Address | Las Vegas, NV 89128-0481 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2008 |
Last Update Date | 12/08/2008 |