MEDICARE: DANIEL E BATLAN PROF CORP

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	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1871034017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL E BATLAN PROF CORP

Provider Business Mailing Address
First Line	:	1930 VILLAGE CENTER CIR
Second Line	:	NO 3-710
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6299
Country	:	US
Telephone Number	:	702-838-8004
Fax Number	:	702-838-5085

Provider Business Practice Location Address
First Line	:	1930 VILLAGE CENTER CIR
Second Line	:	NO 3-710
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6299
Country	:	US
Telephone Number	:	702-838-8004
Fax Number	:	702-838-5085

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL E. BATLAN
Credential	:	MD
Telephone Number	:	702-838-8004

Provider Enumeration Date	:	03/20/2017
Last Update Date	:	04/26/2023

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