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NPI Code Detail

MEDICARE: GEOVANNI J CAMACHO-GALVAN R.T (R)

MEDICARE: GEOVANNI J CAMACHO-GALVAN R.T (R)
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
1247100000XRadiologic Technologist462333NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1462333OTHERAMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS

General Provider Information

NPI Number : 1972921674
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEOVANNI J CAMACHO-GALVAN R.T (R)
Provider Business Mailing Address
First Line : 6175 E OWENS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-1859
Country : US
Telephone Number : 702-306-0325
Fax Number :
Provider Business Practice Location Address
First Line : 6175 E OWENS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-1859
Country : US
Telephone Number : 702-306-0325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2014
Last Update Date : 04/01/2014

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Directions to “ GEOVANNI J CAMACHO-GALVAN R.T (R)” Practice Location

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