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1821932799

NPI Code Detail

MEDICARE: MR. MARTIN PENAFLOR GARCIA III

MEDICARE: MR. MARTIN PENAFLOR GARCIA III

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	374700000X	Technician		NV

General Provider Information

NPI Number	:	1821932799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARTIN PENAFLOR GARCIA III

Provider Business Mailing Address
First Line	:	855 E TWAIN AVE STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-0820
Country	:	US
Telephone Number	:	702-333-2887
Fax Number	:	866-487-5335

Provider Business Practice Location Address
First Line	:	855 E TWAIN AVE STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-0820
Country	:	US
Telephone Number	:	702-333-2887
Fax Number	:	866-487-5335

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

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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1194669069 — MR. VICTORINO FARRALES
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1720922693 — MS. QUMIYA J SHAW
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89169-0820

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1083559132 — MR. LAVEND CARLTON JAMES
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89169-0820

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1619812765 — MS. TIOSHA FORD
Practice Location Address:

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Directions to “ MR. MARTIN PENAFLOR GARCIA III ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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