MEDICARE: COMPREHENSIVE MEDICAL GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1356131593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	4220 SAXTON GREEN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4354
Country	:	US
Telephone Number	:	702-983-6674
Fax Number	:

Provider Business Practice Location Address
First Line	:	3867 S VALLEY VIEW BLVD STE 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2924
Country	:	US
Telephone Number	:	702-758-7628
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	EVANGELINE DE GUZMAN-DELALUZ
Credential	:
Telephone Number	:	702-983-6674

Provider Enumeration Date	:	05/09/2025
Last Update Date	:	11/18/2025

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