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NPI Code Detail

MEDICARE: JOSE S MAGNO

MEDICARE: JOSE S MAGNO
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
1171W00000XContractor

General Provider Information

NPI Number : 1609178854
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE S MAGNO
Provider Business Mailing Address
First Line : 3004 CEDAR ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-4408
Country : US
Telephone Number : 702-457-1048
Fax Number :
Provider Business Practice Location Address
First Line : 3004 CEDAR ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-4408
Country : US
Telephone Number : 702-457-1048
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2010
Last Update Date : 11/20/2010

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Directions to “ JOSE S MAGNO ” Practice Location

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