Healthcare Provider Details

I. General information

NPI: 1376578674
Provider Name (Legal Business Name): CONSOLACION SAQUETON SAQUETON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CONSOLACION SAQUETON COCHRAN MD

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W CHARLESTON BLVD - UNIVERSITY MEDICAL CENTER
LAS VEGAS NV
89102-2329
US

IV. Provider business mailing address

PO BOX 371540
LAS VEGAS NV
89137-1540
US

V. Phone/Fax

Practice location:
  • Phone: 702-383-2420
  • Fax: 702-383-8402
Mailing address:
  • Phone: 702-383-2420
  • Fax: 702-383-8402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number9394
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: