Basic Information
| Provider Information | |||||||||
| NPI: | 1932197290 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DARBARI | ||||||||
| FirstName: | SUNIL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5701 W CHARLESTON BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891461256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023123444 | ||||||||
| FaxNumber: | 7023123510 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 S RAINBOW BLVD | ||||||||
| Address2: | #108 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891464006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026551400 | ||||||||
| FaxNumber: | 7026850612 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2005 | ||||||||
| LastUpdateDate: | 06/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 10673 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 10673 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 100500638 | 05 | NV | MEDICAID |