MEDICARE: ALLOGENETICS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	1041C0700X	Clinical Social Worker
3	207Q00000X	Family Medicine Physician
4	163WW0000X	Wound Care Registered Nurse

General Provider Information

NPI Number	:	1649124710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLOGENETICS LLC

Provider Business Mailing Address
First Line	:	1408 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1408 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8511
Country	:	US
Telephone Number	:	725-724-1958
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DELL JOHN NAVATA
Credential	:
Telephone Number	:	725-724-1958

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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Directions to “ALLOGENETICS LLC ” Practice Location

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