Healthcare Provider Details

I. General information

NPI: 1699962431
Provider Name (Legal Business Name): FRANCISCO PERAZA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5781 W SAHARA AVE STE 500
LAS VEGAS NV
89146-3168
US

IV. Provider business mailing address

PO BOX 26568
LAS VEGAS NV
89126-0568
US

V. Phone/Fax

Practice location:
  • Phone: 702-331-1700
  • Fax:
Mailing address:
  • Phone: 702-732-7440
  • Fax: 702-732-9672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCO PERAZA
Title or Position: PRESIDENT
Credential: MD
Phone: 702-732-7440