MEDICARE: DR. ERIKA CORDERO MAUBAN 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
1	207V00000X	Obstetrics & Gynecology Physician	2020016220	MO
2	207V00000X	Obstetrics & Gynecology Physician	25585	NV

General Provider Information

NPI Number	:	1487279642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIKA CORDERO MAUBAN MD

Provider Business Mailing Address
First Line	:	9970 W CHEYENNE AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7700
Country	:	US
Telephone Number	:	702-978-8900
Fax Number	:	702-978-7617

Provider Business Practice Location Address
First Line	:	9970 W CHEYENNE AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7700
Country	:	US
Telephone Number	:	702-978-8900
Fax Number	:	702-978-7617

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

Provider Enumeration Date	:	06/13/2020
Last Update Date	:	06/03/2024

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