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NPI Code Detail

MEDICARE: CHARLES RALPH GARRIDO SEGUIN

MEDICARE: CHARLES RALPH GARRIDO SEGUIN
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
1363LF0000XFamily Nurse Practitioner832512NV

General Provider Information

NPI Number : 1770355067
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES RALPH GARRIDO SEGUIN
Provider Business Mailing Address
First Line : 6930 S CIMARRON RD STE 260
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2135
Country : US
Telephone Number : 702-499-0739
Fax Number :
Provider Business Practice Location Address
First Line : 6930 S CIMARRON RD STE 260
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2135
Country : US
Telephone Number : 702-476-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2023
Last Update Date : 12/04/2025

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