Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 12548 | NV |
Y | 208600000X | Surgeon | 12548 | NV |
N | 2086S0102X | Surgical Critical Care | 12548 | NV |
NPI | 1063420701 |
---|---|
Provider Name | Dr. Kiarash L Mirkia |
First Address | Las Vegas, NV 89118 |
Second Address | Las Vegas, NV 89118-2556 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 15/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I63463 | (02) | IL |