MEDICARE: ALFREDO A HIBBERT PAC

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	363A00000X	Physician Assistant
2	208000000X	Pediatrics Physician	529	NV
3	207R00000X	Internal Medicine Physician	529	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427153691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFREDO A HIBBERT PAC

Provider Business Mailing Address
First Line	:	5841 E CHARLESTON BLVD
Second Line	:	#230-479
City	:	LAS VEGAS
State	:	NV
Zip	:	89891-6659
Country	:	US
Telephone Number	:	702-734-8014
Fax Number	:	702-921-6828

Provider Business Practice Location Address
First Line	:	4000 E CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-6659
Country	:	US
Telephone Number	:	702-921-6829
Fax Number	:	702-921-6828

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	04/25/2026

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Directions to “ ALFREDO A HIBBERT PAC” Practice Location

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