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NPI Code Detail

MEDICARE: MARIA RACHEL CHOHLIDAKIS M.D.

MEDICARE: MARIA RACHEL CHOHLIDAKIS M.D.
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
1208000000XPediatrics PhysicianA121396CA
2208000000XPediatrics Physician1559NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881970515
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA RACHEL CHOHLIDAKIS M.D.
Provider Business Mailing Address
First Line : 10105 BANBURRY CROSS DRIVE
Second Line : SUITE 370
City : LAS VEGAS
State : NV
Zip : 89144-6649
Country : US
Telephone Number : 702-260-4525
Fax Number : 702-869-0133
Provider Business Practice Location Address
First Line : 10105 BANBURRY CROSS DRIVE
Second Line : SUITE 370
City : LAS VEGAS
State : NV
Zip : 89144-6649
Country : US
Telephone Number : 702-260-4525
Fax Number : 702-869-0133
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2011
Last Update Date : 10/22/2015

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