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NPI Code Detail

MEDICARE: DR. KATHLEEN PATRICIA GATES MD

MEDICARE: DR. KATHLEEN PATRICIA GATES MD
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
1208000000XPediatrics PhysicianA81253CA

General Provider Information

NPI Number : 1427056928
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN PATRICIA GATES MD
Provider Business Mailing Address
First Line : PO BOX 486
Second Line :
City : OVERTON
State : NV
Zip : 89040-0486
Country : US
Telephone Number : 702-467-3498
Fax Number :
Provider Business Practice Location Address
First Line : 3186 S MARYLAND PKWY
Second Line : CHILDREN'S ADMINISTRATION
City : LAS VEGAS
State : NV
Zip : 89109-2317
Country : US
Telephone Number : 701-431-8240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 10/16/2009

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