Canyon Gate Medical Group, LLC

NPI #1013249788 in Las Vegas, Nevada

Provider Information

NPI Number: 1013249788
Entity Type: Organization
Organization Name: Canyon Gate Medical Group, LLC
Primary Specialty: Family Medicine
Enumeration Date: Feb 5, 2010
Last Updated: Feb 5, 2010

Practice Location

Address: 10155 W TWAIN AVE
Address 2: SUITE # 110
City: Las Vegas
State: Nevada
ZIP Code: 89147-6722
Phone: (702) 243-2689

Authorized Official

Name: RICKI MOSKOW
Title: PRESIDENT
Phone: (954) 656-8855

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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