Healthcare Provider Details

I. General information

NPI: 1790623197
Provider Name (Legal Business Name): CHRISTIAN POMPOCO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3014 W CHARLESTON BLVD STE 150
LAS VEGAS NV
89102-0083
US

IV. Provider business mailing address

3014 W CHARLESTON BLVD STE 150
LAS VEGAS NV
89102-0083
US

V. Phone/Fax

Practice location:
  • Phone: 702-478-4837
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number1790623197
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number1790623197
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: